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

doi:10.3877/cma.j.issn.1674-3253.2019.01.002

Abstract

Abstract:

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

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]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(01): 5-9.

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References 16

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手术类别	组别	例数	性别（例）		年龄（岁， ±s ）	BMI（kg/m²， ±s ）
手术类别	组别	例数	男	女	年龄（岁， ±s ）	BMI（kg/m²， ±s ）
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

手术类别	组别	例数	性别（例）		年龄（岁， ±s ）	BMI（kg/m²， ±s ）
手术类别	组别	例数	男	女	年龄（岁， ±s ）	BMI（kg/m²， ±s ）
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

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

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

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