Comparison Between Intraperitoneal CO2 Insufflation and Abdominal Wall Lift on QT Dispersion and Rate-corrected QT Dispersion During Laparoscopic Cholecystectomy

Egawa, Hirotoshi; Morita, Maki; Yamaguchi, Shigeki; Nagao, Michinobu; Iwasaki, Tatsuya; Hamaguchi, Shinsuke; Kitajima, Takamasa; Minami, Junichi

doi:10.1097/00129689-200604000-00004

Cited by 22 publications

(13 citation statements)

References 21 publications

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“…[ 47 ] CO 2 pneumoperitoneum also predisposes the patient to cardiac arrhythmias. [ 49 ] During the early phase of pneumoperitoneum, there is a reduction in the cardiac output[ 46 47 ] by decreasing the venous return. [ 50 ] Although these cardiorespiratory changes may be tolerated by healthy adults with adequate cardiopulmonary reserve, people with cardiopulmonary disease may not be able to tolerate these cardiopulmonary changes.…”

Section: Discussionmentioning

confidence: 99%

Effects of low and standard intra-abdominal pressure on systemic inflammation and immune response in laparoscopic adrenalectomy: A prospective randomised study

et al. 2016

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BACKGROUND:The advantages of laparoscopic adrenalectomy (LA) over open adrenalectomy are undeniable. Nevertheless, carbon dioxide (CO2) pneumoperitoneum may have an unfavourable effect on the local immune response. The aim of this study was to compare changes in the systemic inflammation and immune response in the early post-operative (p.o.) period after LA performed with standard and low-pressure CO2 pneumoperitoneum.MATERIALS AND METHODS:We studied, in a prospective randomised study, 51 patients consecutively with documented adrenal lesion who had undergone a LA: 26 using standard-pressure (12-14 mmHg) and 25 using low-pressure (6-8 mmHg) pneumoperitoneum. White blood cells (WBC), peripheral lymphocyte subpopulation, human leucocyte antigen-DR (HLA-DR), neutrophil elastase, interleukin (IL)-6 and IL-1, and C-reactive protein (CRP) were investigated.RESULTS:Significantly higher concentrations of neutrophil elastase, IL-6 and IL-1 and CRP were detected p.o. in the standard-pressure group of patients in comparison with the low-pressure group (P < 0.05). A statistically significant change in HLA-DR expression was recorded p.o. at 24 h, as a reduction of this antigen expressed on the monocyte surface in patients from the standard group; no changes were noted in low-pressure group patients (P < 0.05).CONCLUSIONS:This study demonstrated that reducing the pressure of the pneumoperitoneum to 6-8 mmHg during LA reduced p.o. inflammatory response and averted p.o. immunosuppression.

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Section: Discussionmentioning

confidence: 99%

Effects of low and standard intra-abdominal pressure on systemic inflammation and immune response in laparoscopic adrenalectomy: A prospective randomised study

et al. 2016

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“…51 CO 2 pneumoperitoneum also predisposes to cardiac arrhythmias. 53 During the early phase of pneumoperitoneum, there is a reduction in the cardiac output 50,51 by decreasing the venous return. 54 Although these cardiorespiratory changes maybe tolerated by healthy adults with adequate cardiopulmonary reserve, people with cardiopulmonary diseases may not tolerate these cardiopulmonary changes.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Randomized Study of Systemic Inflammation and Immune Response After Laparoscopic Nissen Fundoplication Performed With Standard and Low-pressure Pneumoperitoneum

Schietroma

Carlei

Cecilia

et al. 2013

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…A number of small prospective trials have demonstrated that although such an approach causes fewer cardiopulmonary disturbances than pneumoperitoneum, operative times and postoperative pain are increased, with no appreciable differences in morbidity or mortality. 7–10 Although abdominal lift procedures may have a role in very specific patient populations, our results suggest that traditional pneumoperitoneum can be tolerated safely in most patients with CHF.…”

Section: Discussionmentioning

confidence: 80%

Laparoscopy is safe among patients with congestive heart failure undergoing general surgery procedures

Speicher

Ganapathi

Englum

et al. 2014

Surgery

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Background Over the past 2 decades, laparoscopy has been established as a superior technique in many general surgery procedures. Few studies, however, have examined the impact of the use of a laparoscopic approach in patients with symptomatic congestive heart failure (CHF). Because pneumoperitoneum has known effects on cardiopulmonary physiology, patients with CHF may be at increased risk. This study examines current trends in approaches to patients with CHF and effects on perioperative outcomes. Methods The 2005–2011 National Surgical Quality Improvement Program Participant User File was used to identify patients who underwent the following general surgery procedures: Appendectomy, segmental colectomy, small bowel resection, ventral hernia repair, and splenectomy. Included for analysis were those with newly diagnosed CHF or chronic CHF with new signs or symptoms. Trends of use of laparoscopy were assessed across procedure types. The primary endpoint was 30-day mortality. The independent effect of laparoscopy in CHF was estimated with a multiple logistic regression model. Results A total of 265,198 patients were included for analysis, of whom 2,219 were identified as having new or recently worsened CHF. Of these patients, there were 1,300 (58.6%) colectomies, 486 (21.9%) small bowel resections, 216 (9.7%) ventral hernia repairs, 141 (6.4%) appendectomies, and 76 (3.4%) splenectomies. Laparoscopy was used less frequently in patients with CHF compared with their non-CHF counterparts, particularly for nonelective procedures. Baseline characteristics were similar for laparoscopy versus open procedures with the notable exception of urgent/emergent case status (36.4% vs 71.3%; P < .001). After multivariable adjustment, laparoscopy seemed to have a protective effect against mortality (adjusted odds ratio, 0.45; P = .04), but no differences in other secondary endpoints. Conclusion For patients with CHF, an open operative approach seems to be utilized more frequently in general surgery procedures, particularly in urgent/emergent cases. Despite these patterns and apparent preferences, laparoscopy seems to offer a safe alternative in appropriately selected patients. Because morbidity and mortality were considerable regardless of approach, further understanding of appropriate management in this population is necessary.

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Comparison Between Intraperitoneal CO2 Insufflation and Abdominal Wall Lift on QT Dispersion and Rate-corrected QT Dispersion During Laparoscopic Cholecystectomy

Cited by 22 publications

References 21 publications

Effects of low and standard intra-abdominal pressure on systemic inflammation and immune response in laparoscopic adrenalectomy: A prospective randomised study

Effects of low and standard intra-abdominal pressure on systemic inflammation and immune response in laparoscopic adrenalectomy: A prospective randomised study

A Prospective Randomized Study of Systemic Inflammation and Immune Response After Laparoscopic Nissen Fundoplication Performed With Standard and Low-pressure Pneumoperitoneum

Laparoscopy is safe among patients with congestive heart failure undergoing general surgery procedures

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