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Carbon dioxide embolism during transanal total mesorectal excision : A hint of prevention from a case report

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Title: Carbon dioxide embolism during transanal total mesorectal excision : A hint of prevention from a case report
Authors: Fujii, Masakazu Browse this author
Kato, Kentaro Browse this author
Ichimaru, Chisato Browse this author
Kushiya, Hiroki Browse this author
Umemoto, Kazufumi Browse this author
Furukawa, Shotaro Browse this author
Okada, Naoya Browse this author
Imamura, Kiyotaka Browse this author
Yamabuki, Takumi Browse this author
Kinoshita, Yoshihiro Browse this author
Takada, Minoru Browse this author
Ambo, Yoshiyasu Browse this author
Nakamura, Fumitaka Browse this author
Hirano, Satoshi Browse this author →KAKEN DB
Keywords: carbon dioxide embolism
transanal total mesorectal excision
Issue Date: 1-Jul-2022
Publisher: John Wiley & Sons
Journal Title: Asian journal of endoscopic surgery
Volume: 15
Issue: 3
Start Page: 670
End Page: 673
Publisher DOI: 10.1111/ases.13049
Abstract: Transanal total mesorectal excision is a relatively new approach for treating lower rectal cancer. Carbon dioxide embolism is a critical complication of this procedure. We report the case of a 69-year-old man with lower rectal cancer who underwent transanal total mesorectal excision followed by laparoscopic low anterior resection. He had a sudden intraoperative carbon dioxide embolism during the transanal mesorectal excision. During the ventral dissection of the rectum, end-tidal carbon dioxide and blood oxygen saturation suddenly decreased. We stopped the insufflation of carbon dioxide and suspended the procedure. There was no circulatory collapse, and the vital signs gradually recovered; therefore, we resumed the surgery approximately 30 minutes later and completed it without additional complications. Upon reviewing the video, we found a small injured vein that would aspirate carbon dioxide. These findings suggested that careful hemostasis is essential to prevent carbon dioxide embolus during transanal total mesorectal excision.
Rights: This is the peer reviewed version of the following article: Fujii, M, Kato, K, Ichimaru, C, et al. Carbon dioxide embolism during transanal total mesorectal excision: A hint of prevention from a case report. Asian J Endosc Surg. 2022; 15( 3): 670- 673, which has been published in final form at doi:10.1111/ases.13049. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 平野 聡

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