Waseda M, Murakami M, Kato T, Kusano M
Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan.
Minim Invasive Ther Allied Technol. 2005;14(1):14-8. doi: 10.1080/13645700510010782.
The use of laparoscopic surgery contributes to faster recovery of postoperative gastrointestinal motility. Several authors have demonstrated the benefits of laparoscopic surgery using carbon dioxide (CO2) pneumoperitoneum. However, there have been few investigations of the effects of other insufflation gases on gastrointestinal motility. The aim of this study was to investigate the effect of CO2 and helium pneumoperitoneum on the recovery of postoperative gastrointestinal motility. For this study, male Sprague-Dawley rats were divided into four groups: control, CO2 insufflation (10 mmHg), helium insufflation (10 mmHg) and open laparotomy for one hour. Arterial pH values and PaCO2 were measured after surgery. Gastrointestinal motility was evaluated by quantifying the distribution of markers placed into the stomach at the end of procedures until 24 hours after surgery. In the CO2 insufflation group, the arterial pH value was significantly lower than that of the helium insufflation group, and significant hypercapnia persisted until six hours after surgery. The gastric emptying and transit time was significantly prolonged in the CO2 group compared with the helium insufflation group. This study demonstrates that helium pneumoperitoneum can improve the recovery of postoperative gastrointestinal motility because of the reduction of hypercapnia and a tendency to suffer acidosis compared with CO2 pneumoperitoneum.
腹腔镜手术的应用有助于术后胃肠动力更快恢复。几位作者已证明使用二氧化碳(CO₂)气腹进行腹腔镜手术的益处。然而,关于其他充气气体对胃肠动力影响的研究较少。本研究的目的是探讨CO₂和氦气气腹对术后胃肠动力恢复的影响。在本研究中,将雄性Sprague-Dawley大鼠分为四组:对照组、CO₂充气组(10 mmHg)、氦气充气组(10 mmHg)和开腹手术1小时组。术后测量动脉pH值和动脉血二氧化碳分压(PaCO₂)。通过量化手术结束时置于胃内的标志物在术后24小时内的分布情况来评估胃肠动力。在CO₂充气组中,动脉pH值显著低于氦气充气组,且明显的高碳酸血症持续至术后6小时。与氦气充气组相比,CO₂组的胃排空和传输时间显著延长。本研究表明,与CO₂气腹相比,氦气气腹可改善术后胃肠动力的恢复,因为其可减轻高碳酸血症并减少酸中毒倾向。