Effect of different position and CO(2) pneumoperitoneum on deep vein hemodynamics of lower limb / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the effect of laparoscopic surgery position and CO(2) pneumoperitoneum on deep vein hemodynamics of lower limb.</p><p><b>METHODS</b>Color Doppler ultrasound was adopted to evaluate the diameter, blood velocity and the amount of the blood flow in the lower extremity of 37 gastric cancer patients undergone laparoscopic surgery from November 2007 to August 2008 in our hospital. Three kinds of position(prostration, head-down tilt position and feet-down tilt position) before the establishment of pneumoperitoneum and three different pressure of CO(2) pneumoperitoneum( 8 mm Hg, 12 mm Hg, 16 mm Hg ) after the establishment of pneumoperitoneum were applied during laparoscopic surgery.</p><p><b>RESULTS</b>Compared with the stage of prostration before the pneumoperitoneum, the femoral vein diameter decreased (P<0.05), the velocity and the amount of blood flow increased (P<0.01, P<0.05) in head-down tilt position; the femoral vein diameter increased(P<0.01), the velocity and the amount of blood flow decreased(P<0.01, P<0.05) in feet-down tilt position or the establishment of pneumoperitoneum. Furthermore, with the increase of pneumoperitoneum pressure, the femoral vein diameter increased, the velocity and the amount of blood flow decreased(P<0.05).</p><p><b>CONCLUSIONS</b>The head-down tilt position is conducive for the blood to recirculate, which will degrade the risk of deep vein thrombosis after the laparoscopy. The feet-down tilt position and CO(2) pneumoperitoneum can interfere the recirculation of blood, and increase the risk of deep vein thrombosis after the laparoscopy.</p>