末吉　亮
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Pneumoperitoneum and hemodynamic stability during pediatric laparoscopic appendectomy.
Journal Formal name：Journal of pediatric surgery
Abbreviation：J Pediatr Surg
ISSN code：15315037/00223468
Domestic / ForeginForegin
Volume, Issue, Page 51(12),pp.1949-1951
Author and coauthor Miyano Go, Nakamura Hiroki, Seo Shogo, Sueyoshi Ryo, Okawada Manabu, Doi Takashi, Koga Hiroyuki, Lane Geoffrey J, Yamataka Atsuyuki
Publication date 2016/12
Summary BACKGROUND:Conventional pneumoperitoneum (CP) and automatically maintained pneumoperitoneum using AirSeal Intelligent Flow System (AiFS) were compared during pediatric laparoscopic appendectomy (LA) using intraperitoneal pressure (IPP) and hemodynamic parameters.METHODS:A prospective review of 39 children aged 3-14years who had standard 3-trocar LA was performed. Pneumoperitoneum was either AiFS (n=18) or CP (n=21) according to the surgeon's preference. IPP during insertion of trocars in all subjects was initially 8-10mmHg, which was reduced to 5mmHg then maintained until LA was completed. Data were collected every 5min during pneumoperitoneum.RESULTS:Subject demographics were similar for both groups. During pneumoperitoneum, average IPP (AiFS: 7.9; CP: 9.0mmHg), average systolic blood pressure (AiFS: 100.4; CP: 106.9mmHg), and average end-tidal CO2 (EtCO2; AiFS: 35.7; CP: 38.5mmHg) were significantly different (p<.05, respectively), while pulse (AiFS: 92.1; CP: 96.4bpm), oxygen saturation (AiFS: 98.8; CP: 98.8%), body temperature (AiFS: 37.2; CP: 37.4), urine output (AiFS: 2.7; CP: 2.4mL/kg per hour), operative time (AiFS: 72.2; CP: 76.2mins), blood loss (AiFS: 3.6; CP: 3.5mL), recommencement of oral intake (AiFS: 1.3; CP: 1.4days), and postoperative hospitalization (AiFS: 4.3; CP: 3.8days) were not.CONCLUSION:Because IPP was significantly lower during LA with AiFS, EtCO2 and BP were significantly lower.LEVEL OF EVIDENCE:Treatment study; prospective comparative study - level II.
DOI 10.1016/j.jpedsurg.2016.09.016
PMID 28029370