Department of Digestive Surgery, Amiens University Medical Center, Place Victor Pauchet, 80054 Amiens Cedex 01, France.
Hernia. 2012 Feb;16(1):33-40. doi: 10.1007/s10029-011-0849-2. Epub 2011 Jul 20.
Progressive preoperative pneumoperitoneum (PPP) is used to prepare incisional hernias with loss of domain (IHLD) operations. The aim of the present study was to analyze the effect of PPP on peritoneal volume [measured using a new computed tomography (CT)-based method] and respiratory function.
From July 2004 to July 2008, 19 patients were included in a prospective, observational study. The volumes of the incisional hernia (VIH), the abdominal cavity (VAC), the total peritoneal content (VP) and the VIH/VP ratio were measured before and after PPP using abdominal CT scan data. Spirometric parameters were measured before and after PPP, and postoperative clinical data were evaluated.
Before and after PPP, the mean VIH was 1,420 cc and 2,110 cc (P < 0.01), and the mean VAC was 9,083 cc and 11,104 cc (P < 0.01). The VAC increased by 2,021 cc (P < 0.01) and was greater than the mean VIH before PPP. After PPP, the spirometric measurements revealed a restrictive syndrome. The overall postoperative morbidity rate was 37%.
PPP increased the hernia and abdominal volumes. PPP induced a progressive, restrictive syndrome.
逐渐增加术前气腹（PPP）用于准备存在领域缺失的切口疝（IHLD）手术。本研究旨在分析 PPP 对腹膜容量（通过新的基于 CT 的方法测量）和呼吸功能的影响。
从 2004 年 7 月至 2008 年 7 月，19 例患者被纳入前瞻性观察研究。使用腹部 CT 扫描数据，在 PPP 前后测量切口疝（VIH）、腹腔（VAC）、总腹膜内容物（VP）和 VIH/VP 比值的体积。在 PPP 前后测量了肺活量测定参数，并评估了术后临床数据。
在 PPP 前后，VIH 的平均值分别为 1420 cc 和 2110 cc（P < 0.01），VAC 的平均值分别为 9083 cc 和 11104 cc（P < 0.01）。VAC 增加了 2021 cc（P < 0.01），且大于 PPP 前的平均 VIH。在 PPP 后，肺活量测定显示出限制性综合征。总术后发病率为 37%。
PPP 增加了疝和腹部的容量。PPP 引起了逐渐出现的限制性综合征。
