Loss of Physiologic Hepatic Blood Flow Control (“Hepatic Arterial Buffer Response”) During CO2-Pneumoperitoneum in the Rat

Richter, Sven; Olinger, A.; Hildebrandt, U.; Menger, Michael D.; Vollmar, Brigitte

doi:10.1097/00000539-200110000-00014

Cited by 71 publications

(64 citation statements)

References 24 publications

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“…Hydropic degeneration, a reversible lesion found in the specimens analyzed in this study, may be explained mainly by decreased portal blood flow during exposure to pneumoperitoneum, either by vascular compression or decreased venous return due to the high intra-abdominal pressure 19 . The lesions found in both postoperative periods (POD3 and POD7) are in agreement with those reported in previous studies, in which the liver had periods of ischemia and reperfusion [19][20][21] . In addition to ischemic events during gas insufflation, other factors, such as the use of anesthetic drugs and the presence of toxins, also trigger vacuolar degeneration.…”

Section: Effects Of Carbon Dioxide Pneumoperitoneum On Hepatic and Resupporting

confidence: 92%

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Effects of carbon dioxide pneumoperitoneum on hepatic and renal morphology of rats after segmental colectomy and colonic anastomosis

et al. 2011

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PURPOSE: To evaluate the effects of increased intraperitoneal pressure caused by carbon dioxide pneumoperitoneum on the hepatic and renal morphology of rats. METHODS: Fifty-four adult male rats were randomly divided into three groups (P, PP and C) after anesthesia: P - in 18 animals, pneumoperitoneum was established for 30 minutes immediately before laparotomy; PP - in 18 animals, pneumoperitoneum was established for 60 minutes divided into 30 immediately before laparotomy and 30 after abdominal closure; control group (C) - 18 animals underwent laparotomy without pneumoperitoneum induction. The pneumoperitoneum was maintained at a pressure of 5 mm Hg. Nine animals in each group were killed on the 3rd and 7th postoperative days, when kidney and liver samples were collected for morphological analysis. The liver specimens were stained with hematoxylin and eosin (HE), and the kidney specimens, with HE and von Kossa. Blinded examiners analyzed the slides. RESULTS: No changes in renal morphology were found. Liver samples showed histological signs of degeneration in animals in the pneumoperitoneum groups killed on the 7th postoperative day (p=0.029). CONCLUSION: The CO2 pneumoperitoneum did not affect renal morphology but caused hydropic degeneration in the liver of animals killed on the 7th postoperative day.

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Section: Effects Of Carbon Dioxide Pneumoperitoneum On Hepatic and Resupporting

confidence: 92%

“…The reduction of microcirculation causes changes in immune responses, as well as in Kupffer cells and hepatocyte energy metabolism 20 . Recent studies found alternative explanations to changes in both hepatic function and morphology.…”

Section: Effects Of Carbon Dioxide Pneumoperitoneum On Hepatic and Rementioning

confidence: 99%

Effects of carbon dioxide pneumoperitoneum on hepatic and renal morphology of rats after segmental colectomy and colonic anastomosis

et al. 2011

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“…Consequently, it is not surprising that IAH has also been shown to have detrimental effects on the liver. Specifically, the presence of IAH is known to reduce the blood flow in both the hepatic artery (HA) and the portal vein (PV), thus compromising the liver's physiological capacity to regulate its blood flow (9,18). Furthermore, along with these hemodynamic alterations, IAH has also been shown to result in varying degrees of hepatocyte necrosis, as well as impaired hepatic energy metabolism (19)(20)(21).…”

Section: Abstract Background: While Reduction Of Portal Venous (Pv) mentioning

confidence: 99%

Effect of Increased Intra-abdominal Pressure on Liver Histology and Hemodynamics: An Experimental Study

Antoniou

Kairi

Margonis

et al. 2018

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“…To date lower pressure models [39,40] , low-pressure pneumoperitoneum with intermittent deflation at distinct time points [41] and IPC have been attempted to reduce ischemic injury regarding pneumoperitoneum. Many human and animal studies have investigated the effects of increasing intraabdominal pressures (IAP) during laparoscopy and the benefits of low IAP.…”

Section: Iri Secondary To Laparoscopic/robotic Pneumoperitoneummentioning

confidence: 99%

Robotic and laparoscopic urologic surgery ischemic preconditioning

Zor¹,

Ozgok-Kangal²

2018

MIS

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Laparoscopic and robotic assisted surgeries have evolved from a limited surgical procedure to a major surgical technique during the last three decades. The indications increased incrementally. Despite its several advantages, it has some surgery and pneumoperitoneum related adverse effects and hemodynamic complications. One of them is the ischemia reperfusion injury (IRI) of the abdominal organs that can be developed secondary to pneumoperitoneum. IRI is also a risk factor for acute kidney injury in partial nephrectomy surgeries even performed via open, or laparoscopic/ robotic assisted. To reduce or avoid the IRI related complications during laparoscopy and robotics, several alternative approaches were suggested including ischemic preconditioning (IPC). IPC is a phenomenon that promotes tissue tolerance to ischemia. Since it was first introduced, several studies evaluating its protective effects or mechanism of action have been published. Majority of them demonstrated its potent beneficial effects against IRI. Despite these favorable results, IPC has not yet been used in clinical settings routinely. The unknown parts of the exact mechanisms, the lack of standard protocols for its use such as the duration of clamping, the number of clamping cycles, using an early window or a late window, using local IP or remote IP, and the all remaining uncertainly about these aspects of the process might lead clinicians to be hesitant about its clinical use. In this study we discussed what we have in our hands regarding the effects of IRI and protective mechanisms of IPC, animal studies and clinical evidence of IPC, remote and local IPC, laparoscopy/robotics induced IRI, and role of laparoscopic/robotic IPC.

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Loss of Physiologic Hepatic Blood Flow Control (“Hepatic Arterial Buffer Response”) During CO2-Pneumoperitoneum in the Rat

Cited by 71 publications

References 24 publications

Effects of carbon dioxide pneumoperitoneum on hepatic and renal morphology of rats after segmental colectomy and colonic anastomosis

Effects of carbon dioxide pneumoperitoneum on hepatic and renal morphology of rats after segmental colectomy and colonic anastomosis

Effect of Increased Intra-abdominal Pressure on Liver Histology and Hemodynamics: An Experimental Study

Robotic and laparoscopic urologic surgery ischemic preconditioning

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