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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Annals of Colorectal Research
- نوع مقاله: Journal Article
- کلمات کلیدی: Colorectal Surgery,Humidified, warmed Carbon dioxide,Pneumoperitoneum,Core body temperature,Postoperative pain
- چکیده:
- چکیده انگلیسی: Introduction:
Open abdominal surgery exposes the intestine to negative ventilation (20°C, 0-5% RH), which along with the large surface area of peritoneum has the potential to cause loss of body heat. This study examined whether the warmed, humidified CO2 (WHCO2) can reduce heat loss and reduce postoperative pain.
Methods:
A randomized controlled trial was performed at a tertiary colorectal unit (Concord Repatriation General Hospital, The University of Sydney, Australia). The study group received WHCO2 at a rate of 10L/min. The control group did not receive any insufflation during the operation. Patients were over 18 years of age undergoing elective open colorectal operations. Core body temperature measurement was made every 15 minutely with a trans-oesophageal probe. Postoperative pain was assessed via: (1) duration of use of patient controlled analgesia (PCA), (2) total oral morphine equivalent daily dose (oral MEDD).
Results:
39 Patients were recruited in the study, with 20 patients receiving WHCO2. There was no difference in the core body temperature between the WHCO2 and the Control group (36.1 vs. 35.9°C, p=0.35). There was no difference in the % of the operating time where core body temperature dropped below the lower limit of normal of 35.8°C (28.4% vs 35.8%, p=0.51), or to the level of hypothermia of 35°C (7.7% vs. 13.4%, p=0.50). No difference in postoperative PCA duration, as well as MEDD, were noted between the CO2 group and control group.
Conclusion:
WHCO2 had no effect on core body temperature during open colorectal surgery and the postoperative pain experienced.- انتشار مقاله: 18-12-1398
- نویسندگان: JU YONG CHEONG,Anil Keshava,Christopher Young
- مشاهده
- جایگاه : پژوهشی
- مجله: Annals of Colorectal Research
- نوع مقاله: Journal Article
- کلمات کلیدی: lateral pelvic lymph node,low rectal cancer,neoadjuvant therapy
- چکیده:
- چکیده انگلیسی: Lateral pelvic lymph node dissection for advanced low rectal cancer has generated much discussion in the literature in last few years. Whilst it is still being debated as to whether it constitutes a locoregional disease amenable to surgery, or whether it is a distant metastases requiring neoadjuvant therapy, what is clear is that patients with enlarged lateral pelvic lymph nodes have higher rate of recurrence. In this review, we have analysed the current evidence and recommendations for lateral pelvic lymph node dissection. If advanced low rectal cancer (stage II, stage III) below peritoneal reflection, the decision to perform LPLND depends on (1) size of LPLN on MRI (>5mm) prior to neoadjuvant chemoradiotherapy and (2) non-responsive LPLN after CRT (LPLN >5mm before and after CRT). LPLN does prolong the operating time, and greater blood loss, however, is not associated with any greater morbidity. Preservation of the neurovascular structures, including the obturator nerves, hypogastric nerves, and the inferior vesical arteries must be identified and preserved. We have also described the key steps in performing lateral pelvic lymph node dissection.
- انتشار مقاله: 28-12-1398
- نویسندگان: JU YONG CHEONG,Peter Lee,Yoon Suk Lee,Nariman Ahmadi
- مشاهده
- جایگاه : پژوهشی
- مجله: Annals of Colorectal Research
- نوع مقاله: Journal Article
- کلمات کلیدی: lateral pelvic lymph node,low rectal cancer,neoadjuvant therapy
- چکیده:
- چکیده انگلیسی: Lateral pelvic lymph node dissection for advanced low rectal cancer has generated much discussion in the literature in last few years. Whilst it is still being debated as to whether it constitutes a locoregional disease amenable to surgery, or whether it is a distant metastases requiring neoadjuvant therapy, what is clear is that patients with enlarged lateral pelvic lymph nodes have higher rate of recurrence. In this review, we have analysed the current evidence and recommendations for lateral pelvic lymph node dissection. If advanced low rectal cancer (stage II, stage III) below peritoneal reflection, the decision to perform LPLND depends on (1) size of LPLN on MRI (>5mm) prior to neoadjuvant chemoradiotherapy and (2) non-responsive LPLN after CRT (LPLN >5mm before and after CRT). LPLN does prolong the operating time, and greater blood loss, however, is not associated with any greater morbidity. Preservation of the neurovascular structures, including the obturator nerves, hypogastric nerves, and the inferior vesical arteries must be identified and preserved. We have also described the key steps in performing lateral pelvic lymph node dissection.
- انتشار مقاله: 28-12-1398
- نویسندگان: JU YONG CHEONG,Peter Lee,Yoon Suk Lee,Nariman Ahmadi
- مشاهده
- جایگاه : پژوهشی
- مجله: Annals of Colorectal Research
- نوع مقاله: Journal Article
- کلمات کلیدی: Colorectal Surgery,Humidified, warmed Carbon dioxide,Pneumoperitoneum,Core body temperature,Postoperative pain
- چکیده:
- چکیده انگلیسی: Introduction:
Open abdominal surgery exposes the intestine to negative ventilation (20°C, 0-5% RH), which along with the large surface area of peritoneum has the potential to cause loss of body heat. This study examined whether the warmed, humidified CO2 (WHCO2) can reduce heat loss and reduce postoperative pain.
Methods:
A randomized controlled trial was performed at a tertiary colorectal unit (Concord Repatriation General Hospital, The University of Sydney, Australia). The study group received WHCO2 at a rate of 10L/min. The control group did not receive any insufflation during the operation. Patients were over 18 years of age undergoing elective open colorectal operations. Core body temperature measurement was made every 15 minutely with a trans-oesophageal probe. Postoperative pain was assessed via: (1) duration of use of patient controlled analgesia (PCA), (2) total oral morphine equivalent daily dose (oral MEDD).
Results:
39 Patients were recruited in the study, with 20 patients receiving WHCO2. There was no difference in the core body temperature between the WHCO2 and the Control group (36.1 vs. 35.9°C, p=0.35). There was no difference in the % of the operating time where core body temperature dropped below the lower limit of normal of 35.8°C (28.4% vs 35.8%, p=0.51), or to the level of hypothermia of 35°C (7.7% vs. 13.4%, p=0.50). No difference in postoperative PCA duration, as well as MEDD, were noted between the CO2 group and control group.
Conclusion:
WHCO2 had no effect on core body temperature during open colorectal surgery and the postoperative pain experienced.- انتشار مقاله: 18-12-1398
- نویسندگان: JU YONG CHEONG,Anil Keshava,Christopher Young
- مشاهده