Diemunsch P, Becmeur F, Meyer P. Retroperitoneoscopy versus laparoscopy in piglets: ventilatory and thermic repercussions.
J Pediatr Surg 1999;
34:1514-7. [PMID:
10549759 DOI:
10.1016/s0022-3468(99)90115-x]
[Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND/PURPOSE
Endoscopic surgery of the retroperitoneal space in children is developing. During preliminary clinical experience, the authors were surprised by the differences observed in comparison with laparoscopic pneumpoeritoneum (PNOP); retropneumpoeritoneum (RPNOP) seemed to have less ventilatory repercussions.
METHODS
The authors therefore undertook a study on animal models. Six suckling pigs, newly weaned, each weighing 10 kg successively underwent, at 8-day intervals and in random sequence, a right RPNOP with kidney and vena cava dissection, with insufflation of CO2 at 10 mm Hg of pressure and a PNOP with the same pressure of 10 mm Hg.
RESULTS
P(ET)CO2 increased during PNOP, and it remained stable during during RPNOP (P = .035). The ventilatory peak airway pressures (PawP) increased during PNOP, but were not modified during RPNOP (P = .0001). Temperature decreased with time (P = .0001) without difference between the two procedures (P = .34).
CONCLUSIONS
RPNOP was not associated with any adverse effects on the ventilation despite the insufflation pressure of 10 mm Hg, which allowed a satisfactory working area to be created. Operations by RPNOP could be developed in children with fewer respiratory repercussions than those observed during laparoscopy at an equivalent level of pressure.
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