scholarly journals Effect of single-port inflatable mediastinoscopy simultaneous laparoscopic-assisted radical esophagectomy on respiration and circulation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Haibo Ye ◽  
Xiaojin Wang ◽  
Xiaojian Li ◽  
Xiangfeng Gan ◽  
Hongcheng Zhong ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Postoperative Complications ◽  
Partial Pressure ◽  
Single Port ◽  
Perioperative Complications ◽  
Venous Pressure ◽  
Oxygenation Index ◽  
Radical Esophagectomy ◽  
Pressure Peak ◽  
Laparoscopic Assisted

Abstract Background and purpose We previously developed a new surgical method, namely, single-port inflatable mediastinoscopy simultaneous laparoscopic-assisted radical esophagectomy. The purpose of this study was to evaluate the effect of carbon dioxide inflation on respiration and circulation using this approach. Methods From April 2018 to October 2020, 105 patients underwent this novel surgical approach. The changes in respiratory and circulatory functions were reported when the mediastinal pressure and pneumoperitoneum pressure were 10 and 12 mmHg, respectively. Data on blood loss, operative time, and postoperative complications were also collected. Results 104 patients completed the operation successfully, except for 1 patient who was converted to thoracotomy because of intraoperative injury. During the operation, respectively, the heart rate, mean arterial pressure, central venous pressure, peak airway pressure, end-expiratory partial pressure of carbon dioxide and partial pressure of carbon dioxide increased in an admissibility range. The pH and oxygenation index decreased 1 h after inflation, but these values were all within a safe and acceptable range and restored to the baseline level after CO2 elimination. Postoperative complications included anastomotic fistula (8.6%), pleural effusion that needed to be treated (8.6%), chylothorax (0.9%), pneumonia (7.6%), arrhythmia (3.8%) and postoperative hoarseness (18.2%). There were no cases of perioperative death. Conclusions When the inflation pressure in the mediastinum and abdomen was 10 mmHg and 12 mmHg, respectively, the inflation of carbon dioxide from single-port inflatable mediastinoscopy simultaneous laparoscopic-assisted radical esophagectomy did not cause serious changes in respiratory and circulatory function or increase perioperative complications.

scholarly journals Effect of Single-Port Inflatable Mediastinoscopy Simultaneous Laparoscopic-Assisted Radical Esophagectomy On Respiration and Circulation

2021 ◽  
Author(s):  
Haibo Ye ◽  
Xiaojin Wang ◽  
Xiaojian Li ◽  
Xiangfeng Gan ◽  
Hongcheng Zhong ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Postoperative Complications ◽  
Partial Pressure ◽  
Single Port ◽  
Perioperative Complications ◽  
Venous Pressure ◽  
Oxygenation Index ◽  
Radical Esophagectomy ◽  
Pressure Peak ◽  
Laparoscopic Assisted

Abstract Background and Purpose We previously developed a new surgical method, namely, single-port inflatable mediastinoscopy simultaneous laparoscopic-assisted radical esophagectomy. The purpose of this study was to evaluate the effect of carbon dioxide inflation on respiration and circulation using this approach. Methods From April 2018 to October 2020, 105 patients underwent this novel surgical approach. The changes in respiratory and circulatory functions were reported when the mediastinal pressure and pneumoperitoneum pressure were 10 and 12mmHg, respectively. Data on blood loss, operative time, and postoperative complications were also collected. Results 104 patients completed the operation successfully, except for 1 patient who was converted to thoracotomy because of intraoperative injury. During the operation, respectively, the heart rate, mean arterial pressure, central venous pressure, peak airway pressure, end-expiratory partial pressure of carbon dioxide and partial pressure of carbon dioxide increased in an admissibility range. The pH and oxygenation index decreased 1 hour after inflation, but these values were all within a safe and acceptable range and restored to the baseline level after CO2 elimination. Postoperative complications included anastomotic fistula (8.6%), pleural effusion that needed to be treated (8.6%), chylothorax (0.9%), pneumonia (7.6%), arrhythmia (3.8%) and postoperative hoarseness (18.2%). There were no cases of perioperative death. Conclusions When the inflation pressure in the mediastinum and abdomen was 10 mmHg and 12 mmHg, respectively, the inflation of carbon dioxide from single-port inflatable mediastinoscopy simultaneous laparoscopic-assisted radical esophagectomy did not cause serious changes in respiratory and circulatory function or increase perioperative complications.

scholarly journals Defining The Learning Curve of Single-Port Inflatable Mediastinoscopy With Simultaneous Laparoscopic-Assisted Surgery For Radical Esophagectomy

2021 ◽  
Author(s):  
Jinpeng Shi ◽  
Xiaojian Li ◽  
Tianchi Wu ◽  
Xiangwen Wu ◽  
Xiaojin Wang ◽  
...  
Keyword(s):  
Learning Curve ◽  
Single Port ◽  
Thoracoscopic Surgery ◽  
Surgical Team ◽  
Radical Esophagectomy ◽  
Extensive Experience ◽  
Estimated Blood Loss ◽  
Group 2 ◽  
Laparoscopic Assisted ◽  
Group 1

Abstract Background Single-port inflatable mediastinoscopy with simultaneous laparoscopic-assisted surgery for radical esophagectomy is a promising surgical method with high technical requirements and needs team cooperation. Therefore, it is necessary to define a learning curve to guide personnel training and improve the safety of these surgical techniques.Method This study prospectively analyzed the data of 79 consecutive patients, who underwent the surgery in the Fifth Affiliated Hospital of Sun Yat-sen University from October 2016 to May 2018. All of these patients were treated by the same surgical team with extensive experience in thoracotomy, laparotomy, thoracoscopic surgery and laparoscopic surgery. The learning curve was analyzed by cumulative summation (CUSUM) analysis, with the assessment of operative time, estimated blood loss, and postoperative complications.Result By analyzing these data, The scatter diagram of every measure showing a declining situation. The learning curve decreased beginning at 25th operation. All patients were chronologically divided into two groups, the group 1(the first 25 patients) and the group 2 (the last 54 patients). The median estimated blood loss of group 2 was lower than group 1(200 vs 100ml, p<0.05). No other clinic or pathologic characteristics were observed as significantly different.Conclusion For a surgical team with extensive experience in thoracotomy, laparotomy, thoracoscopic surgery and laparoscopic surgery, 25 cases are needed before becoming proficient in this surgery.

scholarly journals Observation on the Nursing Effect of Prone Position Ventilation Applied to Children with Respiratory Failure

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Aili Peng ◽  
Litao Guo ◽  
Jing Xu ◽  
Jingrong Fan
Keyword(s):  
Carbon Dioxide ◽  
Respiratory Failure ◽  
Partial Pressure ◽  
Prone Position ◽  
Pediatric Patients ◽  
Oxygenation Index ◽  
Control Group ◽  
Arterial Partial Pressure ◽  
Arterial Blood ◽  
Experimental Group

Objective — To compare the effects of two prone position ventilation methods on children with respiratory failure, to obtain a safer and more effective way to guide clinical nursing work. Methods — 48 cases of children who were admitted to the intensive care unit of our hospital from February 2018 to August 2019 and applied mechanical ventilation were divided into groups based on a random number table. The odd numbers were included in the experimental group (continuous prone position ventilation group, the duration of continuous prone position exceeded 12 hours, a total of 25 cases). The even numbers were included in the control group (intermittent prone position ventilation group, prone position for 3 hours at a time, alternating with supine position and lateral position, total prone position duration 12 hours, a total of 23 cases). Oxygenation index (OI), PH value, arterial partial pressure of carbon dioxide (PCO2), arterial partial pressure of oxygen (PO2) at 24h, 48h, 72h of the two groups of children, as well as their ventilator use time and ICU hospital stay were compared. Results — Continuous prone position ventilation and intermittent prone position ventilation have no statistical significance on arterial blood carbon dioxide partial pressure (PaCO2), arterial blood oxygen partial pressure (PaO2), ventilator duration, ICU length of stay in children with respiratory failure (P>0.05), but with the increase of the total length of the prone position, when reaching more than 36 hours, the trend of oxygenation index (OI) of the experimental group and the control group can be seen to decline.  Conclusion — In this study, by comparing the effects of two prone position ventilation modes, it was found that intermittent prone position ventilation and continuous prone position ventilation had no difference in the treatment of children with respiratory failure. When children are treated in continuous prone and intermittent prone positions, the total prone position can last up to 36 hours, which can effectively improve the clinical treatment effect. In view of the characteristics of pediatric patients and the difficulty in nursing critically ill patients with tracheal intubation, it is recommended that pediatric patients can use intermittent prone ventilation to complete treatment when the cumulative time in the prone position reaches more than 36 hours.

scholarly journals Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Single Incision ◽  
Single Port ◽  
Operation Time ◽  
Scar Formation ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Skin Scar

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.

scholarly journals The Effect of the Temperature and Moisture to the Permeation Properties of PEO-Based Membranes for Carbon-Dioxide Separation

Polymers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 2053
Author(s):  
Dragutin Nedeljkovic
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
Carbon Dioxide Emission ◽  
Combustion Products ◽  
Mixed Matrix Membranes ◽  
Mixed Matrix Membrane ◽  
Mixed Matrix ◽  
Gas Treatment ◽  
Carbon Dioxide Separation ◽  
Different Temperatures

An increased demand for energy in recent decades has caused an increase in the emissions of combustion products, among which carbon-dioxide is the most harmful. As carbon-dioxide induces negative environmental effects, like global warming and the greenhouse effect, a decrease of the carbon-dioxide emission has emerged as one of the most urgent tasks in engineering. In this work, the possibility for the application of the polymer-based, dense, mixed matrix membranes for flue gas treatment was tested. The task was to test a potential decrease in the permeability and selectivity of a mixed-matrix membrane in the presence of moisture and at elevated temperature. Membranes are based on two different poly(ethylene oxide)-based polymers filled with two different zeolite powders (ITR and IWS). An additive of detergent type was added to improve the contact properties between the zeolite and polymer matrix. The measurements were performed at three different temperatures (30, 60, and 90 °C) under wet conditions, with partial pressure of the water equal to the vapor pressure of the water at the given temperature. The permeability of carbon-dioxide, hydrogen, nitrogen, and oxygen was measured, and the selectivity of the carbon-dioxide versus other gases was determined. Obtained results have shown that an increase of temperature and partial pressure of the vapor slightly increase both the selectivity and permeability of the synthesized membranes. It was also shown that the addition of the zeolite powder increases the permeability of carbon-dioxide while maintaining the selectivity, compared to hydrogen, oxygen, and nitrogen.

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