Effect of persistently elevated intraabdominal pressure on healing of colonic anastomoses

Gas-related impact of pneumoperitoneum on systemic wound healing

“…As for intraabdominal wound healing, experimental investigations about the effects of CO 2 pneumoperitoneum showed an impaired healing of colonic anastomosis with a reduction of 5-hydroxyproline concentrations [1,2].…”

Impact of pressure and gas type on anastomotic wound healing in rats

“…This is rather surprising, in view of the fact that an adequate supply of blood is essential for physiological wound healing, and that several studies demonstrate a significant decrease in splanchnic blood flow, even after a moderate increase in intra-abdominal pressure (IAP) [9][10][11]. These associations are of major importance for laparoscopic surgery, with IAP of 12-15 mmHg often continuing for hours, and with animal studies showing impaired healing of colonic anastomosis with IAP [12,13]. After all, with CO 2 as the most common gas for establishing pneumoperitoneum, knowledge about the gas-specific impact on the healing of anastomosis wounds is rare.…”

Can high risk diseases for increasing intraabdominal pressure be treated more efficiently under intravesical pressure measurement?

“…İAB artışında hemodinamik belirtilerin ortaya çıkmasından çok önce viseral dolaşımın bozulduğu gösterilmiştir. [13][14][15] Çocuk cerrahisinde artmış İAB'nin zararlı etkileri ilk olarak Gross tarafından karın ön duvarı defektli hastaların tedavisinde bildirilmiş ve evreli onarım önerilmiştir. [16] Sonrasında İAB kontrolü altında primer kapatma yıllar içinde daha sık-lıkla kullanılmaya başlanmıştır.…”