Zhu Youzhuang, Wang Weiwei, Liu Dingsheng, Zhang Hong, Chen Lina, Li Zhichao, Qin Shangyuan, Kang Yihan, Chai Jun
Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Anesthesiology, Weihai Municipal Hospital, Cheeloo Colledge of Medicine, Shandong University, Weihai, China.
Front Surg. 2022 May 6;9:873964. doi: 10.3389/fsurg.2022.873964. eCollection 2022.
The actual incidence of carbon dioxide embolism during transanal total mesorectal excision (taTME) is unknown, but the reported incidence in the existing literature is reassuring. However, the incidence of CO embolism, which can be life-threatening, is severely underestimated. By reviewing the available data on carbon dioxide embolism during taTME and synthesizing other reports on CO embolism in laparoscopic procedures, we provide the first comprehensive account of the etiology, pathophysiology, and recommend tools to monitor carbon dioxide embolism during taTME. Additionally, we provide guidance and recommendations on preventive and therapeutic measures to minimize the adverse consequences of this potentially severe complication, knowledge about which we hope will improve patients' safety.
经肛门全直肠系膜切除术（taTME）期间二氧化碳栓塞的实际发生率尚不清楚，但现有文献报道的发生率令人安心。然而，可危及生命的一氧化碳栓塞的发生率却被严重低估。通过回顾taTME期间二氧化碳栓塞的现有数据，并综合腹腔镜手术中其他关于一氧化碳栓塞的报告，我们首次全面阐述了其病因、病理生理学，并推荐了taTME期间监测二氧化碳栓塞的工具。此外，我们提供了预防和治疗措施的指导与建议，以尽量减少这种潜在严重并发症的不良后果，我们希望这些知识能提高患者的安全性。
