A research on placement and management of two different positions during operation in patients with gynecological pelvic tumor

  Objective   To investigate the effects of two different surgical positions in prevention of complications due to lithotomy position in patients with gynecological pelvic malignant tumor.

  Methods  A total of 84 patients with gynecological pelvic malignant tumor were randomly divided into experimental group and control group, with 42 cases in each group. The experimental group was treated with stirrup-shaped multifunctional leg frame, and the venous pressures of lower limbs at the time points of the supine position before surgery (T₀), immediately after the stabilization of lithotomy position (T₁), immediately after 1 h adjustment and stabilization of lithotomy position (T₂), immediately after 2 h adjustment and stabilization of lithotomy position (T₃), immediately after stabilization of the supine position at the end of surgery (T₄) as well as the bleeding volume, operation time and skin compression were recorded. The control group was treated by the traditional leg frame matched with the operating table, the height of the leg frame at the lithotomy position was not changed during the operation, and the relevant parameters at the corresponding time points were recorded.

  Results  There was no significant difference in venous pressure of lower limbs at T₀ between the two groups (P>0.05). Compared with T₀, venous pressure of lower limbs from T₁ to T₄ increased in both groups, but the increase range in the experimental group was significantly smaller and stability of venous pressure of lower limbs was better than those in the control group (P < 0.05). The incidence of stress injury in the experimental group was significantly lower than that in the control group (P < 0.05).

  Conclusion  For patients with lithotomy position and operation time longer than 2 h, the application of stirrup-shaped multifunctional leg frame and dynamic adjustment of body position during operation can reduce the impact on venous pressure of lower limbs, prevent deep venous thrombosis and reduce the incidence of pressure injury caused by lithotomy position.