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Objective To investigate the effect of carbon dioxide pneumoperitoneum on the ox-ygen carrying capacity and electrolyte levels in the salvaged autologous blood undergoing laparoscopic surgery.To evaluate the clinical application value and to provide guidance for the salvage and transfu-sion of autologous blood in laparoscopic surgery.Methods Twenty cases who underwent laparoscopic surgery (group CP,laparoscopic hepatic hemangioma surgery)and twenty cases who underwent open surgery(group NCP,spinal surgery),including eighteen males and twenty-two females,aged 27-79, BMI 1.64-24.46 kg/m2,ASA Ⅰ-Ⅱ,were selected from Peking University People's Hospital from May 2016 to August 2017.Cases in both groups underwent general anesthesia.NBP,IBP,ECG, HR,SpO2,PETCO2,CVP,BIS and T were monitored and autologous blood salvage and transfusion were used during the operation.Arterial blood samples were collected from patients 10 min before and after autologous blood transfusion,salvaged blood samples were collected 1 min before and after fil-tration.Blood gas analysis,including the level of pH,PCO2,PO2,SO2,Hct,Hb,Lac and the con-centrations of Na+,K+,Ca2+,Cl-,Mg2+,were performed on all blood samples.Recording opera-tion time and blood in vitro time,blood loss volume intraoperative,total blood volume of salvage and transfusion.Results In group CP,pH,PO2and SO2of autologous blood 1 min before and after fil-tration were significantly lower than those of arterial blood 10 min before and after autologous blood transfusion (P<0.05).In group NCP,pH of autologous blood 1 min before and after filtration was significantly higher than that of arterial blood 10 min before and after autologous blood transfusion, while PCO2and PO2were significantly lower than the latter(P<0.05).PH,PO2and SO2of autolo-gous blood in group CP were significantly lower while PCO2was significantly higher than group NCP (P<0.05).PH of arterial blood 10 min after autologous blood transfusion was significantly lower while PCO2was significantly higher than group NCP (P<0.05).In group CP,the concentration of Na+and Cl- in autologous blood 1 min after filtration were significantly higher than those before fil-tration and the arterial blood 10 min before and after autologous blood transfusion.The concentration of K+,Ca2+and Mg2+in autologous blood 1 min after filtration were significantly lower than the lat-ter three blood samples (P<0.05).In group NCP,the concentrations of Na+and Cl- in autologous blood 1 min after filtration were significantly higher than those in arterial blood 10 min before and af-ter autologous blood transfusion.The concentrations of K+,Ca2+and Mg2+were significantly lower than those in the latter two blood samples (P<0.05).There were no significant differences in elec-trolyte concentration of all blood samples between two groups.Conclusion The salvaged blood in lap-aroscopic surgery is superacid and carrying less oxygen.After transfusion,may change patients'acid-base balance and increase the risk of acidosis.Its clinical application value need more further explora-tions.
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Objective To compare the effect of different flow rate of oxygen inhalation on relieving scapuledynia after laparoscopic cholecystectomy(LC) with carbon dioxide pneumoperitoneum. Methods 100 patients adopted LC were divided into the 2 L/min group (n=50), the 4 Ldmin group (n=50), both re-ceived oxygen inhalation 6 hours after LC. The incidence and degree of scapulodynia and the blood- gas analysis were analyzed. Results The incidence of scapulodynia after LC in the 4 L/min group was signifi-cantly lower than that of 2 L/min group. PaCO2,PaO2 and pH in the 4 L/min group were different from those of the 2 L/min group. Conclusions Increasing flow rate of oxygen inhalation can relieve incidence and degree of scapulodynia after laparoscopic cholecystectomy.
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Objective To explore the effects of intraperitoneal chemotherapy with fluorouracil(FU) on the growth and metastasis of tumor cells in carbon dioxide(CO2) pneumoperitoneum.Methods Fifty male H-22 mice of clean grade were selected and randomly assigned into 5 groups in each group with 10: simple implantation group,pneumoperitoneum group,pneumoperitoneum and NS group,pneumoperitoneum and low concentration(5.0 g/L) of FU group and pneumoperitoneum and high concentration(10.0 g/L) of FU group.All mice were executed after 11 days to observe the weight and the implantation of tumor in abdominal wall.Then the expressions of proliferating cell nuclear antigen(PCNA) and vascular endothelial growth factor(VEGF) were detected by immunohistochemistry.Results The tumor weight was significantly higher in pneumoperitoneum and high concentration of FU group compared with other groups except pneumoperitoneum and low concentration of FU group(P
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The surgic is the basic method to treat acute peritonitis, and most of the patients are with sep-sis. Recently, with the development of laparoscopic technique, laparoscopic technique has been more and more applied to the treatment sepsis, but the impact on their postoperative inflammatory response and the spread of the bacteria have been the focus of note. Now I make a review, about the research progress of the CO2 pneumoperitonoum in the kind of sepsis in recent years.
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Objective To investigate the effects and mechanism of carbon dioxide (CO_ 2 ) pneumoperitoneum on the adhesive, migratory and invasive abilities of ovarian carcinoma cell line SKOV_ 3 . Methods SKOV_ 3 cells were exposed to an CO_ 2 insufflation medium. The cells′ adhesive ability to Matrigel was analyzed by MTT assayand, and their migratory and invasive abilities were analyzed through Boyden filters metastasis model. CD44 and bFGF expressions were examined by immunohistochemistry and semi-quantitative RT-PCR. Results Cells exposed to an in vitro pneumoperitoneum demonstrate could significantly increase adhesive, migratory and invasive abilities compared to the control group (P
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0.05). Conclusions Carbon dioxide pneumoperitoneum during retroperitoneoscopy has no obvious influence on hepatic functions, renal functions and myocardial enzymogram. It may not cause significant damage to patients with normal heart, hepatic, and renal functions.
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Currently-available imaging techniques provide accurate localization of a tumor in patients with pheochromocytoma. The precision of this information allows the use of a more selective surgical approach to the tumor, such as by laparoscopy. We describe a case of a 54-year-old female who underwent resection of pheochromocytoma by a laparoscopic approach. Two events resulted in significant hemodynamic changes; the creation of the pneumoperitoneum and adrenal gland manupulation. Preoperative preparation with alpha-adrenergic blocking agents and adequate fluid loading before insufflation attenuated intraoperative cardiovascular changes, while titration of sodium nitroprusside and phentolamine allowed easy and quick control of the hemodynamic aberrances related to these processes. As a result, the operation was carried out safely, and the postoperative course was unremarkable.
Subject(s)
Female , Humans , Middle Aged , Adrenal Glands , Adrenalectomy , Adrenergic alpha-Antagonists , Hemodynamics , Insufflation , Laparoscopy , Nitroprusside , Phentolamine , Pheochromocytoma , PneumoperitoneumABSTRACT
Objective:To investigate the effects of carbon dioxide(CO2) pneumoperitoneum on the abdomino-metastatic tumor growth of ovarian carcinoma cell in nude mice and to primarily analyze its mechanism.Methods:The nude mice model of abdomino-metastatic tumor of ovarian carcinoma cell was established,and laparoscopic CO2 pneumoperitoneum environment was simulated.Tumor implantation and growth were observed and tumor tissue apoptosis was detected by TUNNEL method,to explore the effect of CO2 pneumoperitoneum on the abdomino-metastatic tumor growth of ovarian carcinoma cell in nude mice.The expressions of VEGF and MMP9 in cancer tissue were determined by immunohistochemistry and Western Blot to analyze the possible mechanism.Results:After the treatment of CO2 pneumoperitoneum,the tumor quality in abdominal cavity was higher than that of the control group,the expression difference of VEGF and MMP9 in tumor tissues was not significant and tumor cell apoptosis rates of each group do not differ significantly.Conclusions:Carbon dioxide pneumoperitoneum can promote the growth of ovarian carcinoma cell SKOV3.