标题：Low-pressure pneumoperitoneum with abdominal wall lift in laparoscopic total mesorectal excision for rectal cancer:initial experience
作者：Ping-Tian Xia;Maimaiti Yusofu;Hai-Feng Han;Chun-Xiao Hu;San-Yuan Hu;Wen-Bin Yu;Shao-Zhuang Liu
作者机构：[Ping-Tian Xia;Maimaiti Yusofu;Hai-Feng Han;Chun-Xiao Hu;San-Yuan Hu;Wen-Bin Yu;Shao-Zhuang Liu]Department of General Surgery,Qilu Hospital of Shandon 更多
通讯作者地址：[Liu, SZ]Shandong Univ, Qilu Hosp, Dept Gen Surg, 107 Wenhua Xi Rd, Jinan 250012, Shandong, Peoples R China.
关键词：Laparoscopic surgery; Abdominal wall lift; Low-pressure; pneumoperitoneum; Rectal cancer; Total mesorectal excision
摘要：AIM To evaluate the safety and feasibility of a new technology combining low-pressure pneumoperitoneum(LPP) and abdominal wall lift(AWL) in laparoscopic total mesorectal excision(TME) for rectal cancer.METHODS From November 2015 to July 2017,26 patients underwent laparoscopic TME for rectal cancer using LPP(6-8 mm Hg) with subcutaneous AWL in Qilu Hospital of Shandong University,Jinan,China.Clinical data regarding patients’ demographics,intraoperative monitoring indices,operation-related indices andpathological outcomes were prospectively collected.RESULTS Laparoscopic TME was performed in 26 cases(14 anterior resection and 12 abdominoperineal resection) successfully,without conversion to open or laparoscopic surgery with standard-pressure pneumoperitoneum.Intraoperative monitoring showed stable heart rate,blood pressure and paw airway pressure.The mean operative time was 194.29 ± 41.27 min(range:125-270 min) and 200.41 ± 20.56 min(range:170-230 min) for anterior resection and abdominoperineal resection,respectively.The mean number of lymph nodes harvested was 16.71 ± 5.06(range:7-27).There was no positive circumferential or distal resection margin.No local recurrence was observed during a median follow-up period of 11.96 ± 5.55 mo(range:5-23 mo).CONCLUSION LPP combined with AWL is safe and feasible for laparoscopic TME.The technique can provide satisfactory exposure of the operative field and stable operative monitoring indices.