The Effect of Co2 Pneumoperitoneum for Octogenarian During Laparoscopic Rectal Surgery

Chang Sheng-chi, MD, Ke De-wei, MD, William Tzu-liang Chen, MD. China Medical University Hospital, Taichung, Taiwan


Laparoscopic surgery, especially rectal surgery, requests a relative long time and it may cause adverse impact on circulation, respiration and renal function due to CO2 absorption and high intraabdominal pressure. This kind of phenomenon was more obvious in patients of old age. The aim of this study is to compare the anesthetic results between octogenarian and younger patients undergoing laparoscopic rectal surgery perioperatively and to evaluate the effect of pneumoperitoneum in elderly.
Materials and Methods:
Since Jun 2009 to Jun 2011, patients undergoing elective laparoscopic rectal surgery were enrolled in this study, except age from 60 to 80 years old. Patients were divided into two groups, octogenarian (>80y/o, group O) and younger (<60y/o, group Y) group. The parameters were recorded prospectively, including mean blood pressure (MBP), heart rate (HR), cardiac output index (COI), stroke volume index (SVI) and stroke volume variation (SVV), central venous pressure (CVP), end-tidal CO2 (EtCO2), air-way pressure (PAW) and urine output (UO) during anesthesia and pneumoperitoneum. We also compared the perioperative surgical outcome between group O and group Y, including operative time, blood loss, length of first flatus passage, hospital stay, surgical complication and mortality.
In this period, a total of 70 patients were included in this study, 30 octogenarian and 40 younger patients. All patients accept laparoscopic rectal surgery for rectal cancer in the same institute. Although group O had higher ASA degree, the perioperative circulatory parameter seems like similar in both groups. At timing of pneumoperitoneum, the group O had significant increased in CVP level. The short-term surgical results had no significant difference between the two group.
CO2 pneumoperitoneum is safe to octogenarian during laparoscopic rectal surgery and not increase the medical or surgical morbidity after surgery.

Session Number: Poster – Poster Presentations
Program Number: P088
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