| ObjectThrough the clinical application of endoscopic exhaust device,the stability of thoracic pressure during endoscopic esophageal cancer operation can be maintained,and the operation smoke can be quickly eliminated,and the clarity of the operation field can be improved.At the same time,the discharge of surgical smoke for harmless treatment,to ensure the operating room environmental health and air quality.Methods1.This study designed a endoscopic exhaust device for thoracoscopic esophageal cancer surgery(Patent number:ZL 2021 2 2558341.9).The extra water pressure formed by the height difference of distilled water in the exhaust device can ensure the stability of intraoperative thoracic air pressure,and achieve the continuous and stable exhaust of intrathoracic gas,and quickly eliminate the influence of intraoperative smoke on the operation field.The endoscopic exhaust device has the ability to deal with surgical smoke,absorb harmful gas components by adding activated carbon adsorption bottle,and with the use of negative pressure aspirator,the harmless treated gas can be quickly discharged from the operating room to ensure the environment and air quality of the operating room.2.The designed endoscopic exhaust device was applied to the intraoperative nursing of thoracoscopic esophageal cancer surgery assisted by CO2 artificial pneumothorax in a ClassⅢ Grade A hospital in Ningbo,and the effects of the device in intraoperative nursing were evaluated by quasi-experimental research methods.A total of 50 eligible patients who received surgical treatment for esophageal cancer in Li Huili Hospital of Ningbo Medical Center from August 2020 to July 2022 were selected as the study objects,and the corresponding operation method was thoracoscopic three-incision radical resection of esophageal cancer.They were randomly divided into experimental group and control group,with 25 cases in each group.The field clarity,operation time and operating room air quality(CO2,TVOC,PM2.5,PM10)were compared between the two groups.SPSS data statistical software was used to analyze and comprehensively evaluate the advantages and disadvantages of the device in the operation.ResultThe general data of the two groups were compared and analyzed,and there was no statistical difference in the indicators of the general data of the two groups(P>0.05),and the two groups of samples were comparable.Video photography was used to qualitatively observe and record the generation and dissipation process of smoke in the thorax during a single use of electric knife.Smoke accumulation occurred in the thorax of both the observation group and the control group,and the smoke emission rate in the observation group was significantly faster than that in the control group.Compared with the control group(8.20±1.61,211.00±9.88 min),the mean number of lens brushing(4.52±1.29)and operation time(189.48±9.05 min)in the observation group were lower,that is,the number of lens brushing was less and the time was shorter.There were statistical differences between the two groups(P<0.05).In each experiment,the variance of thoracic pressure data in the observation group was lower than that in the control group,and there was a statistical difference between the two groups(P<0.05).In Scenario 1,local air TVOC,PM2.5 and PM 10 contents in the control group(peak content:1.323±0.181 mg/m3,926.23±46.18 μg/m3,839.63±35.24 μg/m3)exceeded the requirements of Indoor Air Quality Standard in a short period of time.The contents of TVOC,PM2.5 and PM10 in the observation group were always maintained at the preoperative level during the observation period.There were statistically significant differences between the two groups(P<0.05)In scenario 2,intraoperative smoke in the whole operating room environment showed a cumulative effect with the increase of operation time;Moreover,the cumulative amount of various smoke components was closely related to the monitoring location,and the overall trend was that the farther the distance from the operating table,the less the cumulative amount.Comparing the monitoring data between the observation group and the control group at different positions,it can also be seen that the contents of various smoke components in each position of the observation group did not exceed the standard requirements.ConclusionThe improved smoke exhaust technique significantly improved the surgical visual field clarity through continuous directional CO2 airflow.The operation time was significantly reduced by reducing the number of intraoperative lens rubbing.The stability of the chest air pressure is obviously improved by the design of continuous exhaust and water sealing.Air pollution in operating room can be effectively avoided by adsorption of activated carbon bottle and drainage of surgical smoke through central negative pressure. |
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