[The transesophageal echocardiographic evaluation of the hemodynamic effects of the pneumoperitoneum in laparoscopic hemicolectomy].
METHODS
Ten patients undergoing laparoscopic left hemicolectomy were monitored by transesophageal echocardiography in order to assess the effects of pneumoperitoneum and head-down tilt on the following parameters: end-diastolic left ventricular volume, stroke volume, cardiac output, left ventricular ejection fraction, mean blood pressure and cardiac frequency. Pneumoperitoneum, by a mean CO2 pressure of 13 mmHg, was performed in five of them; for the other patients, mechanical abdominal wall suspension was used, without any increase in abdominal pressure.


RESULTS
The group treated by abdominal wall suspension underwent an increase in end-diastolic left ventricular dimension, stroke volume, cardiac output and blood pressure, while the group treated by pneumoperitoneum had no significant changes in hemodynamic parameters.


CONCLUSIONS
In this surgical context, pneumoperitoneum seems to be safe and to have a low hemodynamic impact, as its effects on venous return seem to be opposite to those of the Trendelenburg position.
D000368:Aged; D000758:Anesthesia / Q000379:methods; D003082:Colectomy / Q000379:methods* / Q000706:statistics & numerical data; D012809:Colon, Sigmoid / Q000601:surgery; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial / Q000706:statistics & numerical data; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D012007:Rectum / Q000601:surgery; D012811:Sigmoid Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery