title: Physiologic Responses to Infrarenal Aortic Cross-Clamping during Laparoscopic or Conventional Vascular Surgery in Experimental Animal Model: Comparative Study.
abstract: The aim of this study was to compare the hemodynamic and ventilatory effects of prolonged infrarenal aortic cross-clamping in pigs undergoing either laparotomy or laparoscopy. 18 pigs were used for this study. Infrarenal aortic crossclamping was performed for 60 minutes in groups I (laparotomy, n = 6) and II (laparoscopy, n = 6). Group III (laparoscopy, n = 6) underwent a 120-minute long pneumoperitoneum in absence of aortic clamping (sham group). Ventilatory and hemodynamic parameters and renal function were serially determined in all groups. A significant decrease in pH and significant increase in PaCO(2) were observed in group II, whereas no changes in these parameters were seen in group I and III. All variables returned to values similar to baseline in groups I and II 60 minutes after declamping. A significant increase in renal resistive index was evidenced during laparoscopy, with significantly higher values seen in Group II. Thus a synergic effect of pneumoperitoneum and aortic cross-clamping was seen in this study. These two factors together cause decreased renal perfusion and acidosis, thus negatively affecting the patient's general state during this type of surgery.
authors.affiliation: Minimally Invasive Surgery Centre Jesús Usón, Carretera Nac. 521, Km 41.8, 10071 Cáceres, Spain.
authors.forename: María F
authors.initials: MF
authors.lastname: Martín-Cancho
authors.forename: Verónica
authors.initials: V
authors.lastname: Crisóstomo
authors.forename: Federico
authors.initials: F
authors.lastname: Soria
authors.forename: Carmen
authors.initials: C
authors.lastname: Calles
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Sánchez-Margallo
authors.forename: Idoia
authors.initials: I
authors.lastname: Díaz-Güemes
authors.forename: Jesús
authors.initials: J
authors.lastname: Usón-Gargallo