title: [Anesthetic management for laparoscopic sigmoidectomy in a patient with impaired ventricular function caused by cardiac sarcoidosis].
abstract: It has been demonstrated that laparoscopic surgery can reduce surgical trauma and postoperative pain, allowing earlier recovery and hospital discharge. However, because patients with severe cardiac depression may not tolerate the adverse respiratory and cardiovascular effects of pneumoperitoneum with a head-up or head-down tilt position, laparoscopic surgery has been avoided in these patients. The present case with low ventricular function (ejection fraction=23-27%) due to cardiac sarcoidosis could successfully undergo laparoscopic sigmoidectomy by using pulmonary artery catheterization. Therefore, laparoscopic surgery can be performed in patients with cardiac dysfunction if the cardiopulmonary responses caused by pneumoperitoneum with a head-up or head-down tilt are sufficiently considered and adverse hemodynamic responses appropriately detected and treated through invasive monitoring techniques such as pulmonary artery catheterization and/or transesophageal echocardiography.
authors.affiliation: Department of Anesthesiology, Iwate Medical University, School of Medicine, Morioka 020-8505.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nagata
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Sato
authors.forename: Sueko
authors.initials: S
authors.lastname: Oouchi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Wakimoto
authors.forename: Ko
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D000758:Anesthesia; D009202:Cardiomyopathies / Q000150:complications*; D002407:Catheterization, Swan-Ganz; D003082:Colectomy; D012809:Colon, Sigmoid / Q000601:surgery*; D005260:Female; D018475:Head-Down Tilt / Q000502:physiology; D006801:Humans; D010535:Laparoscopy; D016343:Monitoring, Intraoperative; D019990:Perioperative Care; D011028:Pneumoperitoneum, Artificial; D012507:Sarcoidosis / Q000150:complications*; D012811:Sigmoid Neoplasms / Q000601:surgery*; D018754:Ventricular Dysfunction / Q000209:etiology*