Effect of carbon dioxide pneumoperitoneum on tissue blood flow in the peritoneum, rectus abdominis, and diaphragm muscles

Abstract

Despite high intraabdominal pressure, tissues surrounding the abdominal cavity, particularly the peritoneum, respond to insufflation of CO2 with increased blood flow, which may favor the growth of tumor cells.

Hemodynamic and tissue blood flow responses to long-term pneumoperitoneum and hypercapnia in the pig

“…The current study is in agreement with recent studies by us and others showing that CO 2 pneumoperitoneum is associated with a marked increase of blood flow in the peritoneum [5,21]. In addition, the current study provides evidence that this response is related to a local effect of CO 2 on the peritoneal tissue, and not to systemic alterations caused by prolonged CO 2 pneumoperitoneum.…”

“…In experimental animal studies, we and others have shown recently that insufflation of carbon dioxide (CO 2 ) into the abdominal cavity is associated with a marked blood flow increase in the peritoneum, even in the presence of high intraabdominal pressures comparable with those used during laparoscopic surgery [5,21]. This effect was not detected in control experiments with helium (He) insufflation [21].…”

Molecular mechanisms underlying postoperative peritoneal tumor dissemination may differ between a laparotomy and carbon dioxide pneumoperitoneum: a syngeneic mouse model with controlled respiratory support

“…Notably, c-Met and uPAR are both increased in the setting of lowoxygen tension [28][29][30]. Animal experiments have demonstrated that a CO 2 pneumoperitoneum increases noninjured peritoneal blood flow [31,32]. In addition, our previous study demonstrated that the peritoneal tissue oxygen tension levels in noninjured peritoneum during a CO 2 pneumoperitoneum at a low IPP are elevated approximately two times the levels during laparotomy in a mouse laparoscopic model [8].…”

Influence of CO2pneumoperitoneum on intracellular pH and signal transduction in cancer cells

“…Whether CO 2 pneumoperitoneum will promote trocar implantation and extensive abdominal metas- tasis after laparoscopic tumor operation was widely discussed in recent ten years, but there were still no conclusions (Zhang and Kong, 2004;Leister et al, 2003;Yavuz et al, 2003 (Hirabayashi et al, 2002;Lecuru et al, 2002). But these factors could not explain why He pneumoperitoneum would not promote trocar implantation (Neuhaus et al, 1998).…”