Effects of warming carbon dioxide pneumoperitoneum on the prognosis of patients undergoing pancreaticoduodenectomy by Da Vinci robot

Abstract

Objective To study the effect of heated carbon dioxide pneumoperitoneum on the prognosis of patients undergoing pancreaticoduodenectomy by Da Vinci robot. Methods A total of 307 patients who underwent pancreaticoduodenectomy by Da Vinci robot from January 2016 to December 2018 were selected as subjects. 140 patients who underwent pancreaticoduodenectomy from January 2016 to April 2017 were selected as the control group, and room temperature carbon dioxide pneumoperitoneum was used. From May 2017 to December 2018, 167 patients were set as the intervention group, and heated carbon dioxide pneumoperitoneum was used. Body temperature, heart rate and blood oxygen saturation of the two groups were compared after entering the operating room, before anesthesia, before the establishment of carbon dioxide pneumoperitoneum and after the closure of carbon dioxide pneumoperitoneum, and the duration of operation, intraoperative blood loss, postoperative anesthesia recovery time, hospitalization time and postoperative complication rate were recorded. Results There was no significant difference in body temperature after entering the operating room, before the establishment of carbon dioxide pneumoperitoneum between the two groups (P>0.05). After the closure of carbon dioxide pneumoperitoneum, the decline range of the body temperature of the control group was(1.24±2.36) ℃, which was significantly higher than that of the intervention group (0.60±0.25) ℃, and the difference was statistically significant (t value was 6.892, P 0.05). The intraoperative blood loss, resuscitation time, drainage time was (291.08±265.42) ml, (27.04±10.89) min, (8.69±6.64) d in the intervention group and (364.29±309.28) ml, (32.60±12.17) min, (10.76±6.25) d in the control group, and the difference was statistically significant (t value was 2.232, 7.294, 2.789, P<0.05 or 0.01). There was statistically significant difference in The incidence of pancreatic fistula and biliary fistula, and length of hospital stay was 20 cases, 7 cases, (27.62±17.30) d in the intervention group, and 31 cases, 15 cases, (32.38±12.22) d in the control group, and the difference was statistically significant (χ2 value was 4.653, 4.870, t value was 6.284, P<0.05). Conclusions Warming carbon dioxide pneumoperitoneum can reduce the incidence of perioperative hypothermia and improve the prognosis of patients undergoing pancreaticoduodenectomy by Da Vinci robot. Key words: Warming carbon dioxide pneumoperitoneum; Da Vinci robot; Pancreaticod-uodenectomy; Prognosis; Hypothermia