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中华腔镜泌尿外科杂志(电子版)

中华腔镜泌尿外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 5 -9. doi: 10.3877/cma.j.issn.1674-3253.2019.01.002

所属专题： 文献；

临床研究

保持气腹压力的持续排气水封瓶装置在腹腔镜手术中的应用
杨晓健1, 王德娟2, 胡成3, 李科3, 黄文涛3, 邱剑光2,†()   
  1. 1. 510630　广州，中山大学附属第三医院不育与性医学科
    2. 510655　广州，中山大学附属第六医院泌尿外科
    3. 510630　广州，中山大学附属第三医院泌尿外科
  • 收稿日期:2018-03-08 出版日期:2019-02-01
  • 通信作者: 邱剑光
  • 基金资助:
    广东省自然基金(2015A030313031，2017A030313898); 广东省科技计划(2017A020215028); 广州市科技计划(201707010113); 广州市珠江科技新星人才专项(201710010039); 中山大学青年教师培育项目(17ykpy48)

Application of water-sealed bottle with continuous gas exhaust to maintain pneumoperitioneal pressure in laparoscopic surgery

Xiaojian Yang1, Dejuan Wang2, cheng Hu3, Ke Li3, Wentao Huang3, Jianguang Qiu2,†()   

  1. 1. Department of Infertility and Sexual Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
    2. Department of Urology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
    3. Department of Urology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2018-03-08 Published:2019-02-01
  • Corresponding author: Jianguang Qiu
  • About author:
    Corresponding author: Qiu Jianguang, Email:
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引用本文：

杨晓健, 王德娟, 胡成, 李科, 黄文涛, 邱剑光. 保持气腹压力的持续排气水封瓶装置在腹腔镜手术中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(01): 5-9.

Xiaojian Yang, Dejuan Wang, cheng Hu, Ke Li, Wentao Huang, Jianguang Qiu. Application of water-sealed bottle with continuous gas exhaust to maintain pneumoperitioneal pressure in laparoscopic surgery[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(01): 5-9.

目的

研究保持气腹压力的持续排气水封瓶装置在腹腔镜手术中的应用价值。

方法

对中山大学附属第三医院自2016年5月13日至2017年8月10日54例术中应用保持气腹压力的持续排气水封瓶装置的经腹腔入路腹腔镜手术（下称水封瓶组）与54例使用常规排气方法的经腹腔入路腹腔镜手术（下称常规组）按照不同手术方式（前列腺癌根治性切除术、肾部分切除术、肾癌根治性切除术）分别进行回顾性分析，比较两者术中擦镜次数、手术时间、术中出血量、术后引流管引流天数及术后住院天数。

结果

前列腺癌根治性切除术、肾部分切除术、肾癌根治性切除术水封瓶组术中擦镜次数均明显少于常规组（三组均P<0.001），三种术式水封瓶组和常规组手术时间差异均有统计学意义（P=0.015、0.046、0.024），三种术式间水封瓶组和常规组的术中出血量、术后引流管引流天数、术后住院天数差异均无统计学意义。

结论

保持气腹压力的持续排气水封瓶装置既能及时排出术中产生的烟雾和废气，又能持续保持恒定的工作气压，大大提高腹腔镜手术的操作效率，降低手术时间。该设计简单方便、经济实惠，值得在各种腹腔镜手术中加以推广。

关键词: 气腹, 持续排气, 水封瓶, 腹腔镜, 回顾性
Objective

To evaluate the application value of water-sealed bottle with continuous gas exhaust to maintain pneumoperitioneal pressure in laparoscopic surgery.

Methods

From May 13, 2016 to August 10, 2017, clinical data of 54 patients undergoing transperitoneal laparoscopic surgery using water sealed bottle with continuous gas exhaust to maintain pneumoperitioneal pressure (the water sealed bottle group), and 54 cases of transperitoneal laparoscopic surgery using conventional gas exhaust (conventional group) were retrospectively analyzed according to different surgical methods, such as radical resection of prostate cancer, partial nephrectomy and radical nephrectomy of kidney cancer. The times of laparoscopic lens cleaning, operation time, intraoperative blood loss, days of postoperative drainage and the length of postoperative hospital stay were statistically compared between the two groups.

Results

In the water-sealed bottle group, the times of laparoscopic lens cleaning during radical prostatectomy, partial nephrectomy and radical nephrectomy were significantly less than that in the conventional group (all P<0.001). The operation time of three types of surgeries significantly differed between the water-sealed bottle and conventional groups (P=0.015, 0.046, 0.024). The intraoperative blood loss, days of postoperative drainage and the length of postoperative hospital stay of three types of operations did not significantly differ between two groups.

Conclusions

The water sealed bottle with continuous gas exhaust can maintain pneumoperitioneal pressure, discharge the frog and gas intraoperatively, maintain the working pressure stable, significantly enhance the surgical efficiency and shorten the operation time of laparoscopic surgery. It is a convenient and economical surgical approach, which deserves widespread application in different types of laparoscopic surgeries.

Key words: Pneumoperitoneum, Continuous gas exhaust, Water-sealed bottle, Laparoscopy, Retrospective
表1 水封瓶组和常规组患者一般资料的比较
手术类别 组别 例数 性别（例） 年龄（岁， ±s ） BMI（kg/m2， ±s ）
男 女
前列腺癌根治性切除术（不含淋巴结清扫） 水封瓶组 16 16 0 68±6 21.0±2.3
常规组 16 16 0 67±6 21.2±2.0
统计值 ? - t=0.621- t=-0.343
P值 ? 1.000 0.539 0.734
肾部分切除术 水封瓶组 20 09 11 053±10 21.0±1.4
常规组 20 11 09 054±10 21.2±1.8
统计值 ? χ2=0.400 t=-0.222 t=-0.342
P值 ? 0.527 0.826 0.734
肾癌根治性切除术（不含淋巴结清扫） 水封瓶组 18 07 11 60±7 21.0±1.8
常规组 18 10 08 59±7 21.3±1.8
统计值 ? - t=0.114- t=-0.416
P值 ? 0.505 0.910 0.680
表2 水封瓶组和常规组患者手术相关各项指标的比较
手术类别 组别 擦镜次数[M（Q）] 手术时间（min） 术中出血量（ml，±s） 术后引流管引流时间[d，M（Q）] 术后住院时间[d，M（Q）]
前列腺癌根治性切除术（不含淋巴结清扫） 水封瓶组 3.0(2.0) 152±28 64±15 7.0(2.0) 10.0(2.8)0
常规组 8.0(1.5) 175±22 68±15 7.0(1.0) 10.0(2.0)0
统计值 Z=-4.893 t=-2.590 t=-0.708 Z=-1.089 Z=-0.308
P值 <0.001 0.015 0.485 0.305 0.780
肾部分切除术 水封瓶组 2.5(1.0) 106±21 62±17 3.0(2.0) 7.0(1.8)
常规组 7.5(1.0) 122±26 60±13 3.5(1.0) 7.0(2.0)
统计值 Z=-5.482 t=-2.063 t=0.517- Z=-1.335 Z=-0.803
P值 <0.001 0.046 0.608 0.201 0.445
肾癌根治性切除术（不含淋巴结清扫） 水封瓶组 3.0(2.0) .88±12 45±12 4.5(2.0) 7.0(2.0)
常规组 8.0(2.0) 101±20. 42±10 5.0(1.0) 7.0(2.0)
统计值 Z=-5.178 t=-2.397 t=0.941- Z=-0.761 Z=-0.050
P值 <0.001 0.024 0.354 0.481 0.963
[1]
Ficarra V, Novara G, Artibani W, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review andcumulative analysis of comparative studies[J]. Eur Urol, 2009, 55(5): 1037-1063.
[2]
Favaretto RL, ShariatSF, Chade DC, et al. Comparison between laparoscopic and open radical nephroureterectomy in a contemporary group of patients: Are recurrence and disease-specific survival associated with surgical technique? [J]. Eur Urol, 2010, 58(5): 645-651.
[3]
谢立平，汪松，王潇. 2016年EAU/AUA微创泌尿外科技术进展及热点关注[J/CD]. 中华腔镜泌尿外科杂志(电子版), 20l6, 10(4): 219-221.
[4]
邱剑光，高新. 腹腔镜肾周腹膜后隙解剖及手术入路[M]. 泌尿外科手术学, 北京: 人民卫生出版社, 2007, 843-853.
[5]
邱剑光. 层面外科腹腔镜膀胱根治性切除术(附光盘)[J]. 现代泌尿外科杂志, 2017, 22(4): 241-248.
[6]
梅傲冰，邱剑光，贾本忠，等. 肾前筋膜间平面无血化腹腔镜手术层面的解剖学研究[J/CD]. 中华腔镜泌尿外科杂志(电子版), 20l3, 7(2): 86-91.
[7]
Calhoun JT, Redan JA. Elimination of laparoscopic lens fogging using directional flow of CO2[J]. JSLS, 2014, 18(1): 55-61.
[8]
Ohdaira T, Nagai H, Kayano S, et al. Antifogging effects of a socket-type device with the superhydrophilic, titanium dioxide-coated glass for the laparoscope[J]. Surg Endosc, 2007, 21(2): 333-338.
[9]
Manning TG, Papa N, Perera M, et al. Laparoscopic lens fogging: solving a common surgical problem in standard and robotic laparoscopes via a scientific model[J]. Surg Endosc, 2018, 32(3): 1600-1606.
[10]
Drysch A, Schmitt K, Uribe B, et al. Comparative analysis of techniques to prevent laparoscopic fogging[J]. Minim Invasive Ther Allied Technol, 2016, 25(6): 319-322.
[11]
Runia AJ, Zengerink JF, Mannaerts GH. Easy cleaning of the scope's lens in a syringe to prevent condensation during laparoscopic surgery[J]. Surg Endosc, 2009, 23(12): 2849-2850.
[12]
Manning TG, Perera M, Christidis D, et al. Visual occlusion during minimally invasive surgery: a contemporary review of methods to reduce laparoscopic and robotic lens fogging and other sources of optical loss[J]. J Endourol, 2017, 31(4): 327-333.
[13]
Lawrentschuk N, Fleshner NE, Bolton DM. Laparoscopic lens fogging: a review of etiology and methods to maintain a clear visual field[J]. J Endourol, 2010, 24(6): 905-913.
[14]
Shirk GJ, Johns A, Redwine DB. Complications of laparoscopic surgery: How to avoid them and how to repair them[J]. J Minim Invasive Gynecol, 2006, 13(4): 352-359.
[15]
Wang HK, Mo F, Ma CG, et al. Evaluation of fine particles in surgical smoke from an urologist's operating room by time and by distance [J]. Int Urol Nephrol, 2015, 47(10): 1671-1678.
[16]
García-Segui A, Sánchez M, Verges A, et al. Narrowing of the dorsal vein complex technique during laparoscopic radical prostatectomy: a simple trick to simplify the control of venous plexus[J]. Urol J, 2014, 11(5): 1873-1877.
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