Our Summary

This research paper is about the use of two different types of carbon dioxide (CO2) during colorectal surgeries. Traditionally, a cold, dry CO2 is used to create space in the body for the surgeons to work during laparoscopic surgeries (where small incisions are made, rather than one large one). However, this gas can cause the patient’s body temperature to drop, leading to complications. Some studies suggest that a warm, humidified CO2 might help maintain the patient’s normal body temperature.

To confirm this, the researchers looked at high-quality studies that compared the use of warm, humidified CO2 to the traditional cold, dry CO2 or to no gas at all in the operating room. They focused on changes in the patient’s internal body temperature, but also considered other factors such as how long the patient stayed in the hospital, how long the surgery took, when normal gut function came back, whether there was a wound infection, and the level of pain after surgery.

The researchers found six such studies involving 418 patients. They found that there was no significant difference in body temperature changes between patients who were given warm, humidified CO2 and those given cold, dry CO2 or no gas. However, patients who received the warm, humidified CO2 reported more pain the day after surgery. There were no significant differences in the other factors considered.

In conclusion, the researchers found that using warm, humidified CO2 in colorectal surgeries doesn’t seem to offer any significant benefits over the traditional cold, dry CO2. Patients, doctors, and hospitals should consider a variety of factors when deciding which type of gas to use.

FAQs

  1. What are the potential complications of using cold, dry CO2 in colorectal surgeries?
  2. Did the research find any significant benefits of using warm, humidified CO2 in colorectal surgeries?
  3. What factors should be considered when deciding the type of CO2 gas to use in colorectal surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about colorectal surgery is to discuss the type of gas used during the procedure with their surgeon. It is important for patients to be informed about the potential benefits and drawbacks of using warm, humidified CO2 versus cold, dry CO2. Patients should also discuss any concerns they have about maintaining their body temperature during surgery and how it may impact their recovery. By having an open and informed conversation with their healthcare team, patients can make the best decision for their individual needs and optimize their surgical outcomes.

Suitable For

Patients who are typically recommended colorectal surgery include those with:

  1. Colorectal cancer: Surgery is often the primary treatment for colorectal cancer, especially in the early stages.

  2. Diverticulitis: Severe cases of diverticulitis, where there are complications such as abscesses or fistulas, may require surgical intervention.

  3. Inflammatory bowel disease (Crohn’s disease, ulcerative colitis): Surgery may be necessary to treat complications such as strictures, fistulas, or severe inflammation that does not respond to medication.

  4. Polyps: Large or precancerous polyps found during a colonoscopy may need to be removed surgically.

  5. Rectal prolapse: Surgery may be needed to repair a rectal prolapse, where the rectum protrudes through the anus.

  6. Colonic inertia: In cases of severe constipation that does not respond to other treatments, surgery to remove part of the colon may be necessary.

  7. Fecal incontinence: In some cases, surgery may be recommended to improve control over bowel movements.

It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if colorectal surgery is the best course of action for their individual case.

Timeline

Before colorectal surgery, a patient typically undergoes pre-operative testing, meets with their surgeon to discuss the procedure, and follows pre-operative instructions such as fasting and taking medications as advised. On the day of surgery, the patient will be prepped for the procedure, which may include anesthesia administration and placement of IV lines.

During the surgery, the patient is under anesthesia and the surgeon performs the necessary procedures to address the colorectal issue. Depending on the type of surgery, the patient may have a laparoscopic procedure with small incisions or an open surgery with a larger incision. The surgeon will remove any diseased tissue, repair any damage, and close the incisions.

After the surgery, the patient is taken to the recovery room where they are monitored for any complications. They may experience pain, fatigue, and discomfort, and will likely have restrictions on their activity and diet. The patient will be given instructions on wound care, medications, and follow-up appointments.

In the days and weeks following surgery, the patient will continue to recover at home. They may experience changes in bowel function, pain, and discomfort as their body heals. It is important for the patient to follow their surgeon’s instructions, attend follow-up appointments, and contact their healthcare provider if they experience any concerning symptoms.

Overall, colorectal surgery is a significant procedure that requires careful preparation, skilled execution, and thorough post-operative care to ensure the best possible outcomes for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about colorectal surgery include:

  1. What type of gas will be used during the surgery – cold, dry CO2, warm, humidified CO2, or no gas at all?
  2. What are the potential benefits and risks of using warm, humidified CO2 compared to the traditional cold, dry CO2?
  3. How will the choice of gas impact my body temperature during and after the surgery?
  4. How long can I expect to stay in the hospital after the surgery?
  5. How long is the typical recovery time for this type of surgery?
  6. What is the likelihood of experiencing complications such as wound infections?
  7. How will the choice of gas affect my level of pain after the surgery?
  8. Are there any other factors I should consider when deciding on the type of gas to be used during the surgery?
  9. What is the surgeon’s experience and success rate with using warm, humidified CO2 in colorectal surgeries?
  10. Are there any alternative methods or technologies that could be considered for creating space in the body during the surgery?

Reference

Authors: Sharma S, McKechnie T, Khamar J, Wu K, Hong D, Eskicioglu C. Journal: Colorectal Dis. 2024 Jan;26(1):7-21. doi: 10.1111/codi.16798. Epub 2023 Nov 20. PMID: 37985859