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Objective To evaluate the feasibility of laparoscopically robotic assisted radical hysterectomy and pelvic lymphadenectomy in treatment of cervical cancer.Methods From Dec.2008 to Aug.2009,5 cervical cancer patients at stage Ⅰ bl to Ⅱ a underwent laparoscopically robotic assisted radical hysterectomy and pelvic lymphadenectomy.The following clinical parameters were recorded and compared,including operative time,blood loss,intraoperative and postoperative complications,the changes of hemoglobin before and after surgery,postoperative temperature,the time of postoperative anus exhaust and urination,hospitalization,pathologic exam,and the number of lymph nodes.Results Laparoscopically robotic assisted radical hysterectomy and pelvic lymphadenectomy were performed successfully on those 5 patients without the conversion to laparotomy.No intraoperative and postoperative complications were observed.The operative time were 305,365,275,240 and 245 minutes,respectively,with a mean value of 286 minutes.Estimated blood loss was 200,400,650,300 and 400 ml,respectively.The mean blood loss was 390 ml.Temperatures of all patients were not higher than 37.5℃ and anus exhaust was recovered at 36 hours after surgery.Those five patients were hospitalized for 11,13,9,12 and 12 days respectively.Squamous carcinoma of cervix were diagnosed by the pathologic examination.The resected margin of vagina and parametrium was clear.The numbers of pelvic lymph nodes were 14,22,16,21 and 18,respectively.No evidence of lymph nodes metastasis was found.Conclusion Laparoscopically robotic assisted radical hysterectomy and pelvic lymphadenectomy is feasible as a novel approach in the treatment of cervical cancer.
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Objective To compare the influences of peridural and general anesthesia on respiration and circulation in gynecological laparoscopic operation. Methods Fifty-six patients, underwent gynecological laparoscopic operation during June to October, 2003, are divided into two groups. The items of respiration and circulation recorded before and 10, 20, 30, 40min after pneumoperitoneum as well as 5 min after deflation abdomen were as follows: blood pressure (BP), heart rate (HR), sphygmus oxygen saturation (SpO_2), end-expiratory pressure of CO_2 (P_ ETCO_2), tidal volume, frequency of respiration, minute ventilation volume and airway pressure. Results The re-consciousness time after the operation in the peridural anesthesia group is significantly less than that in the general anesthesia group (P0.05). Conclusion In gynecological laparoscopic operation, no significant difference was found concerning the influence of the two anesthesia manners on respiration and circulation.
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Objective To investigate the effects of CO 2 pneumoperitoneum on circulation, P ET CO 2 and blood gas during laparoscopic hepatectomy. Methods Fourteen patients underwent laparoscopic hepatectomy with CO 2 pneumoperitoneum. The MAP, HR, CVP, P ET CO 2 , airway pressure and blood gas were monitored respectively before, 30min, 60min, 120min after pneumoperitoneum, and 10min and 30min after deflation of the abdomen. Results The HR, P ET CO 2 , PaCO 2 , and plood K + were significantly higher 30min after pneumoperitoneum compared with the values before pneumoperitoneum (P
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Objective To investigate the effect of nicardipine on the time-response relationships of vecuronium and atracuriumMethods Forty ASA grade Ⅰ-Ⅱ patients undergoing elective surgical operations were randomly allocated to four groups A single dose of vecuronium was intravenously administered at twice ED 95(01mg?kg -1) in groupⅠand combined with nicardipine 20?g?kg -1 in group Ⅱ Atracurium was given at the dose of twice ED 95 (05mg?kg -1) in groupⅢ and combined with nicardipine in group Ⅳ Anaesthesia was maintained with 50% nitrous oxide in oxygen and fentanyl in all groups Neuromuscular function was monitored with Biometer accelographResults The onset time of vecuronium was shortened from 26 min (groupⅠ) to 20 min (groupⅡ) (P
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0.05). In the general anesthesia group, glucose level at 10 minutes after pneumoperitoneum was significantly lower than that before anesthesia (P0.05). Conclusion Both epidural and general anesthesia can effectively inhibit the patients' stress response in laparoscopic gynecological operation.