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

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

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。

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 watersealed 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.