Portal de investigación
An Individualized Low-Pneumoperitoneum-Pressure Strategy May Prevent a Reduction in Liver Perfusion during Colorectal Laparoscopic Surgery.
Fecha de publicación:
Fecha Ahead of Print:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Olmedilla Arnal, Luis Enrique
- Cambronero, Oscar Diaz
- Perez Pena, Jose Maria
- Zorrilla Ortuzar, Jaime
- Rodriguez Martin, Marcos
- Vila Montanes, Maria
- Schultz, Marcus
- Rovira, Lucas
- On Behalf Of The IPPColLapSe Ii Investigators
Grupos
Abstract
High intra-abdominal pressure (IAP) during laparoscopic surgery is associated with reduced splanchnic blood flow. It is uncertain whether a low IAP prevents this reduction. We assessed the effect of an individualized low-pneumoperitoneum-pressure strategy on liver perfusion. This was a single-center substudy of the multicenter 'Individualized Pneumoperitoneum Pressure in Colorectal Laparoscopic Surgery versus Standard Therapy II study' (IPPCollapse-II), a randomized clinical trial in which patients received an individualized low-pneumoperitoneum strategy (IPP) or a standard pneumoperitoneum strategy (SPP). Liver perfusion was indirectly assessed by the indocyanine green plasma disappearance rate (ICG-PDR) and the secondary endpoint was ICG retention rate after 15 min (R15) using pulse spectrophotometry. Multivariable beta regression was used to assess the association between group assignment and ICG-PDR and ICG-R15. All 29 patients from the participating center were included. Median IAP was 8 (25th-75th percentile: 8-10) versus 12 (12,12) mmHg, in IPP and SPP patients, respectively (p < 0.001). ICG-PDR was higher (OR 1.42, 95%-CI 1.10-1.82; p = 0.006) and PDR-R15 was lower in IPP patients compared with SPP patients (OR 0.46, 95%-CI 0.29-0.73; p = 0.001). During laparoscopic colorectal surgery, an individualized low pneumoperitoneum may prevent a reduction in liver perfusion.
Datos de la publicación
- ISSN/ISSNe:
- 2227-9059, 2227-9059
- Tipo:
- Article
- Páginas:
- -
- PubMed:
- 36979870
- Enlace a otro recurso:
- www.scopus.com
- Factor de Impacto:
- 0,874 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
Biomedicines MDPI
Citas Recibidas en Web of Science: 5
Citas Recibidas en Scopus: 4
Documentos
- No hay documentos
Filiaciones
Keywords
- colorectal surgery; laparoscopic colorectal surgery; laparoscopy; low-impact laparoscopy; perioperative medicine; pneumoperitoneum
Campos de Estudio
Cita
Olmedilla LE,Cambronero OD,MAZZINARI G,Perez JM,Zorrilla J,Rodriguez M,Vila M,Schultz M,Rovira L,ARGENTE MP,On Behalf Of The IPPColLapSe Ii I. An Individualized Low-Pneumoperitoneum-Pressure Strategy May Prevent a Reduction in Liver Perfusion during Colorectal Laparoscopic Surgery. Biomedicines. 2023. 11. (3):891. IF:3,900. (1).