| A comparison of gasless mechanical and conventional carbon dioxide pneumoperitoneum methods for laparoscopic cholecystectomy. | |
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MedLine Citation:
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PMID: 9428871 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Carbon dioxide (CO2) insufflation with increased intraabdominal pressure (IAP) has adverse hemodynamic, pulmonary, and renal effects. To avoid these problems, an abdominal wall lift method with a retractor was used to provide the surgical view without CO2 insufflation. Twenty-six patients undergoing elective laparoscopic cholecystectomy were randomly allocated to either the gasless, retractor group, or conventional CO2 pneumoperitoneum group (CPP). Hemodynamic data, ventilatory variables, urine output, urine oxygen tension, and blood samples for determining stress hormones were collected throughout the perioperative period. Patients in the retractor group had lower mean arterial pressure, heart rate, and central venous pressure (P < 0.001). They also had higher pulmonary dynamic compliance and needed a lower minute volume of ventilation to achieve normocarbia (P < 0.001). Urine output and oxygen tension in urine were higher (P < 0.05) with the retractor method than with CPP. Increase in plasma renin activity (P < 0.05) and decrease in core temperature (P < 0.001) were smaller with the gasless method than with CPP. The gasless method for laparoscopic cholecystectomy might be beneficial, especially in patients with compromised cardiorespiratory or renal function. Implications: Totally gasless laparoscopic cholecystectomy was compared with conventional pressure pneumoperitoneum with CO2 insufflation. The gasless method resulted in more stable hemodynamics and pulmonary function, as well as higher urine, output than conventional pressure pneumoperitoneum. No changes in renal oxygenation was seen with the gasless method, compared with conventional pressure pneumoperitoneum. |
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Authors:
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A M Koivusalo; I Kellokumpu; M Scheinin; I Tikkanen; H Mäkisalo; L Lindgren |
Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 86 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 1998 Jan |
Date Detail:
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Created Date: 1998-01-29 Completed Date: 1998-01-29 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 153-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Anaesthesia, University of Helsinki, Finland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Pressure Carbon Dioxide / pharmacology* Catecholamines / blood Cholecystectomy, Laparoscopic* Female Humans Male Middle Aged Pneumoperitoneum, Artificial / methods* Prospective Studies Vasopressins / secretion |
| Chemical | |
Reg. No./Substance:
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0/Catecholamines; 11000-17-2/Vasopressins; 124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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