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首页> 外文期刊>Surgical Endoscopy >Transcutaneous monitoring of partial pressure of carbon dioxide during endoscopic submucosal dissection of early colorectal neoplasia with carbon dioxide insufflation: a prospective study.
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Transcutaneous monitoring of partial pressure of carbon dioxide during endoscopic submucosal dissection of early colorectal neoplasia with carbon dioxide insufflation: a prospective study.

机译：经皮内监测早期大肠肿瘤的内镜黏膜下剥离术中二氧化碳分压的二氧化碳前瞻性研究。

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BACKGROUND: The authors have reported that carbon dioxide (CO(2)) insufflation is safe and effective for lengthy endoscopic submucosal dissection (ESD) with the patient under conscious sedation. However, CO(2) monitoring has not been assessed to clarify whether partial pressure of carbon dioxide (PCO(2)) increases during this type of long procedure. This study aimed to monitor CO(2) before, during, and after ESD to investigate whether CO(2) insufflation is safe for patients receiving a lengthy ESD of early colorectal neoplasia under conscious sedation. METHODS: This study prospectively enrolled 35 consecutive patients who underwent ESD at the National Cancer Center Hospital. Transcutaneous PCO(2) (PtcCO(2)) was measured with a noninvasive sensor before, during, and after ESD for patients under conscious sedation using midazolam. RESULTS: The mean size of removed lesions was 44 +/- 22 mm (range, 15-100 mm). The operation time was 90 +/- 100 min (range, 15-600 mm). The dose of midazolam was 5.7 +/- 4.0 mg (range, 2-19 mg). The mean PtcCO(2) was 41 +/- 5 mmHg (range, 33-53 mmHg) before ESD and 44 +/- 6 mmHg (range, 32-54 mmHg) afterward. The mean peak PtcCO(2) during ESD was 55 +/- 7 mmHg (range, 39-78 mmHg), which was significantly higher than before or after ESD (p < 0.0001). However, no complication associated with CO(2) insufflation such as CO(2) narcosis, gas embolism, or arrhythmia needing treatment was seen in any of the cases. CONCLUSIONS: This study suggests that CO(2) insufflation is safe for patients receiving a lengthy colorectal ESD under conscious sedation.
机译：背景：作者报告说，二氧化碳（CO（2））吹气对于患者在有意识的镇静下进行长时间的内镜黏膜下剥离术（ESD）是安全有效的。但是，尚未评估CO（2）监测来澄清这种长时间过程中二氧化碳分压（PCO（2））是否增加。这项研究旨在监测ESD之前，期间和之后的CO（2），以调查在有意识的镇静作用下接受早期大肠肿瘤形成长期ESD的患者，CO（2）吹入是否安全。方法：本研究前瞻性纳入了在美国国家癌症中心医院接受ESD治疗的35例连续患者。在使用咪达唑仑进行有意识镇静的患者进行ESD之前，期间和之后，使用无创传感器测量了经皮PCO（2）（PtcCO（2））。结果：切除的病灶的平均大小为44 +/- 22毫米（范围15-100毫米）。手术时间为90 +/- 100分钟（范围为15-600毫米）。咪达唑仑的剂量为5.7 +/- 4.0 mg（范围2-19 mg）。 PtcCO（2）的平均值在ESD之前为41 +/- 5 mmHg（范围33-53 mmHg），之后为44 +/- 6 mmHg（范围32-54 mmHg）。 ESD期间的平均峰值PtcCO（2）为55 +/- 7 mmHg（范围39-78 mmHg），明显高于ESD之前或之后（p <0.0001）。但是，在任何情况下都没有发现与CO（2）吹入有关的并发症，例如CO（2）麻醉，气体栓塞或心律不齐。结论：这项研究表明CO（2）吹气对于在有意识的镇静下接受长时间大肠直肠ESD的患者是安全的。

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