Novosti
Khirurgii
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Year 2012 Vol. 20 No 4

GENERAL AND SPECIAL SURGERY

V.E. KORIK 1, S.A. ZHIDKOV 2, D.A. KLYUYKO 1

OXYGENATION CHANGE OF THE ABDOMINAL ORGANS AT LAPAROSCOPY SURGERIES IN VARIOUS GASEOUS MEDIA

EE Belarusian State Medical University 1 Minsk
Military Medical Administration of the Ministry of Defence of the Republic of Belarus2
The Republic of Belarus

Objectives. To study the impact of carbon dioxide and synthetic air insufflated to the abdominal cavity on the respiratory activity of the abdominal cavity organs of patients undergoing laparoscopic cholecystectomy.
Methods. Two groups of patients (62 patients in each group) with calculous cholecystitis were included in the investigation. To create a working space for the laparoscopic procedures in the first group carbon dioxide was used; in the second synthetic air. Investigation of the influence of gases on the internal organs oxygenation (liver, peritoneum and small intestine) was studied by the direct oximetry at the beginning of the operation (after setting the ports), insufflation of gas at the end of surgery prior to the removal of the tools.
Results. On insufflation of carbon dioxide the oxygen utilization rate by the peritoneum increased from 198,5 to 264,9 mm Hg/min, at the same time the oxygen content in it 2 times decreased from 125,4 to 64,2 mm Hg. The tissue respiration rate in the intestinal wall increased from 347,3 to 549,5 mm Hg/min and oxygen partial pressure increased from 121,9 to 144,7 mm Hg. The tissue respiration rate in the liver decreased from 215,8 to 73,4 mm Hg/min, and oxygen partial pressure increased from 74,3 to 132,3 mm Hg. While using the air gaseous mixture, statistically significant differences between the findings obtained at the beginning and at the end of the operation were not revealed.
Conclusions. The obtained data suggest that the peritoneum is easily permeable both to carbon dioxide and oxygen; in consequence of this the use of carbon dioxide markedly inhibits the oxygenation of the border tissue and causes acidemia. The air gaseous mixture has no significant effect on the respiratory activity of the organs and tissues.

Keywords: laparoscopy, cholecystectomy, oximetry, oxygenation
p. 29 -37 of the original issue
References

1. Beliaev AIu, Nikolaeva IP. Sravnitel'naia otsenka gazoobmena i kislorodno-shchelochnogo sostoianiia pri laparoskopicheskikh ginekologicheskikh operatsiiakh, vypolnennykh po gazovoi i bezgazovoi metodike [Comparative evaluation of gas exchange and oxygen-base status in laparoscopic gynecological operations performed in the accordance of the "gas" and "gasless" method]. Endoskop Khirurgiia. 2000;(2):1012.
2. Korik VE. Karboksiperitoneum pri laparoskopicheskikh operatsiiakh neobkhodimost' al'ternativy [Carboxyperitonium in laparoscopic operation - alternative]. Voen Meditsina. 2009;(4):7375.
3. Volz J, Koster S, Spacek Z, Paweletz N. Characteristic alterations of the peritoneum after carbon dioxide pneumoperitoneum. Surg Endosc. 1999 Jun;13(6):61114.
4. De Souza AM, Wang CC, Chu CY, Lam PM, Rogers MS. The effect of intra abdominal pressure on the generation of 8-iso prostaglandin F2? during laparoscopy in rabbits. Hum Reprod. 2003 Oct;18(10):218188.
5. Jacobs VR, Kiechle M, Morrison JE Jr. Carbon dioxide gas heating inside laparoscopic insufflators has no effect. JSLS. 2005 Apr-Jun;9(2):20812.
6. Suginami R, Taniguchi F, Suginami H. Prevention of postlaparoscopic shoulder pain by forced evacuation of residual CO(2). JSLS. 2009 Jan-Mar;13(1):5659.
7. Korik VE. Vliianie karboksiperitoneuma i pnevmoperitoneuma na kislotno-osnovnoe sostoianie krovi [Carboxyperitonium and pneuperitonium effect on blood acid-base status]. Novosti Khirurgii. 2011;(4):3135.
8. Titovets EP. Akvaporiny cheloveka i zhivotnykh: fundamental'nye i klinicheskie aspekty [Aquaporins of man and animals: basic and clinical aspects]. Minsk, RB: Belnauka, 2007. 239 p.
9. Blank ME, Ehmke H. Aquaporin-1 and HCO3(-)-Cl- transporter-mediated transport of CO2 across the human erythrocyte membrane. J Physiol. 2003 Jul 15;550(Pt 2):41929.
10. Ivanov II, Loktyushkin AV, Gus'kova RA, Vasil'ev NS, Fedorov GE, Rubin AB. Oxygen channels of erythrocyte membrane. Dokl Biochem Biophys. 2007 May-Jun;414:13740.
11. Borgnia M, Nielsen S, Engel A., Agre P. Cellular and molecular biology of the aquaporin water channels. Annu Rev Biochem. 1999;68:42558.
12. Musa-Aziz R, Chen LM, Pelletier MF, Boron WF. Relative CO2/NH3 selectivities of AQP1, AQP4, AQP5, AmtB, and RhAG. Proc Natl Acad Sci U S A. 2009 Mar 31;106(13):540611.

Address for correspondence:
220034, Respublika BelarusMinsk, ul. Azgura, d. 4, UO Belorusskiy gosudarstvennyiy meditsinskiy universitet, voenno-meditsinskiy fakultetkafedra voenno-polevoy hirurgii
e-mail: kluiko@list.ru,
Klyuyko Dmitriy Aleksandrovich
Information about the authors:
Korik V.E., Candidate of Medical Sciences, Associate Professor, Colonel of Medical Service, Head of Military Field Surgery Chair of the Military Medicine Faculty of EE "Belarusian State Medical University."
Zhidkov S.A., Doctor of Medical Sciences, Professor, Colonel of Medical Service, the Chief of Military Medical Department of the Ministry of Defense of the Republic of Belarus
Klyuyko D.A., Major of Medical Service, Graduate Student of The Chair of MilitaryField Surgery of the Military Medicine Faculty of EE "Belarusian State Medical University."
Contacts | ©Vitebsk State Medical University, 2007