Prospective, randomized, clinical trial on the effects of laparoscopic insufflation pressures on portal pressures in dogs.
Journal
Veterinary surgery : VS
ISSN: 1532-950X
Titre abrégé: Vet Surg
Pays: United States
ID NLM: 8113214
Informations de publication
Date de publication:
21 Feb 2024
21 Feb 2024
Historique:
revised:
30
11
2023
received:
07
08
2023
accepted:
28
01
2024
medline:
21
2
2024
pubmed:
21
2
2024
entrez:
21
2
2024
Statut:
aheadofprint
Résumé
The adverse effects of intra-abdominal pressure from capnoperitoneum on cardiovascular and pulmonary systems have been well documented, but the effects on portal pressures in dogs with various insufflation pressures is poorly defined. The aim of the present study was to measure the effect of a range of insufflation pressures on the portal pressure, using direct pressure measurements in patients undergoing laparoscopy. Clinical randomized prospective study. Nine client-owned dogs undergoing routine laparoscopy. Two rounds of direct portal pressure assessments were performed, at insufflation pressures of 0, 6, 10, and 14 mmHg in a predetermined randomized sequence. The data were analyzed for effects of insufflation pressure, hemodynamic alterations, and round. A best-fit exponential model of the relationship between portal pressure and insufflation pressure was created. Portal pressure increased by 38% at 6 mmHg, 95% at 10 mmHg, and 175% at 14 mmHg compared to baseline. Portal pressure increased at an average rate of 7.45% per mmHg of insufflation pressure. Effects of weight, weight/insufflation pressure interaction, and round of insufflation were not statistically significant. No systemic hemodynamic adverse events were observed. Portal pressure increased as insufflation pressure increased. There was no clinically significant difference in baseline portal pressure between rounds of insufflation. This exponential model of portal pressure supports the use of the minimum insufflation pressure to allow visualization during laparoscopy. The return of portal pressure to baseline following desufflation supports the comparison of portal pressure measurements before and after laparoscopic shunt attenuation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Références
Bleedorn JA, Dykema JL, Hardie RJ. Minimally invasive surgery in veterinary practice: a 2010 survey of Diplomates and residents of the American College of Veterinary Surgeons. Vet Surg. 2013;42:635-642.
Devitt CM, Cox RE, Hailey JJ. Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs. J Am Vet Med Assoc. 2005;227:921-927.
Mayhew PD, Culp WTN, Hunt GB, et al. Comparison of perioperative morbidity and mortality rates in dogs with noninvasive adrenocortical masses undergoing laparoscopic versus open adrenalectomy. J Am Vet Med Assoc. 2014;245:1028-1035.
Mayhew PD, Freeman L, Kwan T, Brown DC. Comparison of surgical site infection rates in clean and clean-contaminated wounds in dogs and cats after minimally invasive versus open surgery: 179 cases (2007-2008). J Am Vet Med Assoc. 2012;240:193-198.
Ishizaki Y, Bandai Y, Shimomura K, Abe H, Ohtomo Y, Idezuki Y. Changes in splanchnic blood flow and cardiovascular effects following peritoneal insufflation of carbon dioxide. Surg Endosc. 1993;7:420-423.
Jakimowicz J, Stultiëns G, Smulders F. Laparoscopic insufflation of the abdomen reduces portal venous flow. Surg Endosc. 1998;12:129-132.
Scott J, Singh A, Valverde A. Pneumoperitoneum in veterinary laparoscopy: a review. Vet Sci. 2020;7:E64.
Ivankovich AD, Miletich DJ, Albrecht RF, Heyman HJ, Bonnet RF. Cardiovascular effects of intraperitoneal insufflation with carbon dioxide and nitrous oxide in the dog. Anesthesiology. 1975;42:281-287.
Greif WM, Forse RA. Hemodynamic effects of the laparoscopic pneumoperitoneum during sepsis in a porcine endotoxic shock model. Ann Surg. 1998;227:474-480.
Hejazi M, Pedram MS, Ashegh H, Jafari N, Ghazisaeedi F, Abdi M. Evaluation of effects of intraperitoneal CO2 pressure in laparoscopic operations on kidney, pancreas, liver and spleen in dogs. Iran Red Crescent Med J. 2013;15:809-812.
Lee JY, Choi SH. Results of hepatic and renal function tests to different CO2 pneumoperitoneum conditions: an experimental capnoperitoneum study in dogs. Res Vet Sci. 2015;101:1-5.
Miller JM, Fowler JD. Laparoscopic portosystemic shunt attenuation in two dogs: Multimeda content. J Am Anim Hosp Assoc. 2006;42:160-164.
Poggi E, Rubio DG, Pérez Duarte FJ, et al. Laparoscopic portosystemic shunt attenuation in 20 dogs (2018-2021). Vet Surg. 2022;51(1-12):O138-O149.
Izzo F, Poggi E, Pérez Duarte FJ, Cinti F. Laparoscopic portosystemic shunt attenuation in two cats. J Feline Med Surg Open Rep. 2022;8:20551169221081416.
Gutt CN, Schmedt CG, Schmandra T, Heupel O, Schemmer P, Büchler MW. Insufflation profile and body position influence portal venous blood flow during pneumoperitoneum. Surg Endosc. 2003;17:1951-1957.
Schmandra TC, Kim ZG, Gutt CN. Effect of insufflation gas and intraabdominal pressure on portal venous flow during pneumoperitoneum in the rat. Surg Endosc. 2001;15:405-408.
Klopfenstein C-E, Morel DR, Clergue F, Pastor CM. Effects of abdominal CO2insufflation and changes of position on hepatic blood flow in anesthetized pigs. Am J Physiol-Heart Circ Physiol. 1998;275:H900-H905.
Pastor CM, Morel DR, Clergue F, Mentha G, Morel P. Effects of abdominal Co2 insufflation on renal and hepatic blood flows during acute hemorrhage in anesthetized pigs. Crit Care Med. 2001;29:1017-1022.
Blobner M, Bogdanski R, Kochs E, Henke J, Findeis A, Jelen-Esselborn S. Effects of Intraabdominanlly insufflated carbon dioxide and elevated Intraabdominal pressure on splanchnic circulation: an experimental study in pigs. Anesthesiology. 1998;89:475-482.
Berent A, Tobias K. Hepatic Vascular Anomalies. In: Johnston S, Tobias K, eds. Veterinary Surgery: Small Animal. Elsevier; 2018:1852-1886.
Swalec KM, Smeak DD. Partial versus complete attenuation of single portosystemic shunts. Vet Surg VS. 1990;19:406-411.
Bostwick DR, Twedt DC. Intrahepatic and extrahepatic portal venous anomalies in dogs: 52 cases (1982-1992). J Am Vet Med Assoc. 1995;206:1181-1185.