Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	119733
Country	China

Category	Surgery
Manuscript Type	Case Report
Article Title	Carbon dioxide embolism during salvage transanal total mesorectal excision in “frozen pelvis”: Two case reports
Manuscript Source	Unsolicited Manuscript
All Author List	Cai-Ping Li and Yi-Ming Lv
Funding Agency and Grant Number
Corresponding Author	Yi-Ming Lv, MD, Department of Colorectal Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 Qingchun Road, Shangcheng District, Hangzhou 310016, Zhejiang Province, China. elliottlv@zju.edu.cn
Key Words	Carbon dioxide embolism; Transanal total mesorectal excision; Frozen pelvis; Salvage surgery; Perioperative nursing; Case report
Core Tip	This case series serves as a critical warning on the significant intraoperative hazard of salvage transanal total mesorectal excision: Dense fibrosis resulting from prior multimodality treatment creates “non-collapsible veins” that remain open when injured, allowing massive carbon dioxide (CO2) influx. The investigators highlight the diagnostic biphasic capnographic signature-initial hypocapnia followed by rebound hypercapnia-as a key observational point for differentiating CO2 embolism from other causes of intraoperative collapse, and emphasize the vital role of perioperative nursing collaboration in the successful management of such crises.
Citation	Li CP, Lv YM. Carbon dioxide embolism during salvage transanal total mesorectal excision in “frozen pelvis”: Two case reports. World J Gastrointest Surg 2026; In press

Received	2026-02-07 03:28
Peer-Review Started	2026-02-07 03:29
First Decision by Editorial Office Director	2026-02-26 08:25
Return for Revision	2026-02-26 08:51
Revised	2026-03-09 15:29
Publication Fee Transferred	2026-03-10 11:09
Second Decision by Editor	2026-03-23 02:49
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-03-23 07:34
Articles in Press	2026-03-23 07:34
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9366 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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