[Effect of different position and CO(2) pneumoperitoneum on deep vein hemodynamics of lower limb].
OBJECTIVE
To study the effect of laparoscopic surgery position and CO(2) pneumoperitoneum on deep vein hemodynamics of lower limb.


METHODS
Color Doppler ultrasound was adopted to evaluate the diameter, blood velocity and the amount of the blood flow in the lower extremity of 37 gastric cancer patients undergone laparoscopic surgery from November 2007 to August 2008 in our hospital. Three kinds of position(prostration, head-down tilt position and feet-down tilt position) before the establishment of pneumoperitoneum and three different pressure of CO(2) pneumoperitoneum( 8 mm Hg, 12 mm Hg, 16 mm Hg ) after the establishment of pneumoperitoneum were applied during laparoscopic surgery.


RESULTS
Compared with the stage of prostration before the pneumoperitoneum, the femoral vein diameter decreased (P<0.05), the velocity and the amount of blood flow increased (P<0.01, P<0.05) in head-down tilt position; the femoral vein diameter increased(P<0.01), the velocity and the amount of blood flow decreased(P<0.01, P<0.05) in feet-down tilt position or the establishment of pneumoperitoneum. Furthermore, with the increase of pneumoperitoneum pressure, the femoral vein diameter increased, the velocity and the amount of blood flow decreased(P<0.05).


CONCLUSIONS
The head-down tilt position is conducive for the blood to recirculate, which will degrade the risk of deep vein thrombosis after the laparoscopy. The feet-down tilt position and CO(2) pneumoperitoneum can interfere the recirculation of blood, and increase the risk of deep vein thrombosis after the laparoscopy.
Wang
Yu
Y
Research Institute of General Surgery, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, China. flyfishwang@Hotmail.com
Wang
Yan-ting
YT
Jiang
Yan-yan
YY
Lin
Ya-hua
YH
Zou
Zhong-dong
ZD
D000328:Adult; D001783:Blood Flow Velocity; D002245:Carbon Dioxide; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018475:Head-Down Tilt; D006439:Hemodynamics; D006801:Humans; D010535:Laparoscopy; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011187:Posture; D011312:Pressure; D013274:Stomach Neoplasms / Q000503:physiopathology* / Q000601:surgery; D014463:Ultrasonography
D002245:Carbon Dioxide