Cardiopulmonary changes during laparoscopy and vessel injury: comparison of CO 2 and helium in an animal model

Jacobi, C. A.; Junghans, T.; Peter, Frank; Naundorf, Dorothea; Ordemann, J.; Müller, J. M.

doi:10.1007/s004230000172

Cited by 11 publications

(6 citation statements)

References 27 publications

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“…Insufflation with carbon dioxide results in hypercapnia, acidosis, and increased pCO 2 as well as increased endtidal CO 2 [16,17]. In addition to these changes it is not surprising that our investigations show acidosis of the intra-and extracellular milieu after insufflation with CO 2 .…”

Section: Discussionmentioning

confidence: 72%

Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function

Wildbrett

Naundorf

et al. 2003

Surg Endosc

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Section: Discussionmentioning

confidence: 72%

Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function

Wildbrett

Naundorf

et al. 2003

Surg Endosc

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“…Whether pressure exerts an antagonistic or agonistic effect is as controversial as it is contradictory [26][27][28] . However, the consensus evidence suggests that increasing pressures stimulate intra-abdominal tumour growth.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Environmental Changes during Surgery Enhance the Invasive Potential of Tumours

Paraskeva¹,

Ridgway²,

Jones³

et al. 2005

Tumor Biol

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Objective: The use of laparoscopic techniques in resection of malignant tumours has been proposed to offer potential benefit to the patient in the form of earlier recovery and less immune paresis; however, reported tumour seeding, both peritoneal and at port site, has put this approach into question. The biological effects of the introduction of carbon dioxide or helium to form a pneumoperitoneum on tumour invasion and dissemination are unknown. Methods: A human colonic adenocarcinoma cell line (SW1222) was exposed to in vitro laparoscopic environment of either carbon dioxide or helium for 4 h, mimicking the duration of a laparoscopic colorectal resection. Alteration in production of matrix metalloproteinase (MMP)-2, MMP-9 and urokinase-type plasminogen activator (uPA) due to exposure to a laparoscopic environment was determined by zymogra phy and correlated to invasive capacity by a standard Matrigel-based invasion assay. Incorporation of specific gelatinase inhibitors or antibodies directed at the uPA receptor was utilized to determine the relative importance of proteases. Results: Exposure to the laparoscopic environment significantly enhanced production of the proteases MMP-2, MMP-9 and uPA. A concomitant enhancement of invasive capacity was also observed, being blocked by specific protease inhibitors. Changes in both protease production and aggression were observable for at least 24 h following the removal of the operative environment, indicating the possible long-term effects of the initial insult. Conclusion: Exposure to the laparoscopic environment enhances the invasive capacity of colonic adenocarcinomas via a well-defined protease-determined pathway. It therefore appears likely that tumour cells released into the operative field can be made increasingly aggressive by a laparoscopic operative environment and can thus contribute to disease dissemination.

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“…Systemic acidosis is a consistent finding with CO 2 pneumoperitoneum, and a local peritoneal pH as low as 6.2 has been observed in humans (unpublished data from pilot-study). Alternative gases have been considered [1] and helium seems to be safe, as it is a small molecule that easily passes through tissue, apparently without creating gas embolisms [2]. It is also non-combustible and does not create acidic conditions in contact with water.…”

mentioning

confidence: 99%

Peritoneal and systemic pH during pneumoperitoneum with CO2 and helium in a pig model

et al. 2007

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Cardiopulmonary changes during laparoscopy and vessel injury: comparison of CO 2 and helium in an animal model

Abstract: The incidence of gas embolism during laparoscopy and accidental vessel injury seems to be very low. With the exception of acidosis and an increase of PETCO2 in the CO2 group, there were no differences in cardiopulmonary function between insufflation of CO2 and helium.

Cited by 11 publications

References 27 publications

Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function

Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function

Laparoscopic Environmental Changes during Surgery Enhance the Invasive Potential of Tumours

Peritoneal and systemic pH during pneumoperitoneum with CO2 and helium in a pig model

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