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Impact of modified concave lithotomy position on respiratory mechanics and hemodynamics in patients undergoing three-dimensional laparoscopic radical resection and radiotherapy for rectal cancer
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H. Cui   , T. Qiao , X. Zhu |
| Department of Anesthesiology and Surgery, Jianhu County People's Hospital, Yancheng 224700, Jiangsu Province, China , 13961903707@163.com |
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Abstract: (12 Views) |
Background: Preoperative pelvic radiotherapy for rectal cancer can induce tissue fibrosis and impair cardiopulmonary reserve, complicating perioperative management. Modified concave lithotomy positioning may help mitigate these challenges. This study evaluated the influence of preoperative radiotherapy and modified concave lithotomy position on intraoperative respiratory mechanics and hemodynamics in rectal cancer patients. Materials and Methods: Eighty patients with rectal cancer who had received standardized neoadjuvant radiotherapy were randomly divided into two groups: observation group (modified concave lithotomy position) and control group (traditional lithotomy position). Respiratory and circulatory parameters were recorded at key intraoperative time points, along with operation time, blood loss, complications, and recovery indicators. Results: At 30 min after surgery through the end of operation, peak inspiratory pressure, plateau pressure, and mean airway pressure were significantly lower, while dynamic and static lung compliance were higher in the modified position group. Heart rate and central venous pressure were lower, and mean arterial pressure was higher in the modified group (P<0.05). Operation time, blood loss, and complication rates were reduced, with faster postoperative recovery. Subgroup analysis indicated that patients with radiation-induced pelvic fibrosis had decreased lung compliance overall, but the modified position partially alleviated this effect. Conclusion: In rectal cancer patients following preoperative radiotherapy, modified concave lithotomy positioning improves intraoperative respiratory mechanics, stabilizes hemodynamics, and promotes safer perioperative outcomes. These findings emphasize the importance of individualized positioning strategies for radiotherapy-treated surgical patients. |
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| Keywords: Radiotherapy, adjuvant, rectal neoplasms, patient positioning, respiratory mechanics, hemodynamics, intraoperative care. |
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Full-Text [PDF 1002 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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