title: Carbon dioxide insufflation causes upper urinary tract injury in the early period of an experimental vesicoureteral reflux model.
abstract: OBJECTIVE
  Ureteral reimplantation via pneumovesicum is a new aspect of vesicoureteral reflux management. We aimed to determine the effects of carbon dioxide (CO2) insufflation on the upper urinary tract in an experimental model.
  
  
  METHODS
  Thirty New Zealand rabbits were allocated into five groups of six rabbits each. Right ureters were cannulated for CO2 insufflation in four groups. The pressures and durations of CO2 insufflation in the respective groups were as follows: Group A (10 mm Hg, 2 h); B (12 mm Hg, 2 h); C (10 mm Hg, 4 h); and D (12 mm Hg, 4 h) and control (E). Blood gas analysis, urea and creatinine levels were measured from renal veins and aorta. Histopathological evaluation of the renal parenchyma and ureters was scored.
  
  
  RESULTS
  Significant histopathological changes were detected in the ipsilateral ureter and renal parenchyma exposed to CO2 insufflation, predominantly observed in groups insufflated for longer durations, p < 0.05. Blood gases drawn separately from renal veins were significantly more acidotic, and serum urea and creatinine levels were increased in all the groups, p < 0.05.
  
  
  CONCLUSIONS
  CO2 causes significant histopathological and biochemical changes in the early period. Long-term results are required to determine whether permanent renal injury occurs.
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey, hkilincaslan@gmail.com.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Kilincaslan
authors.forename: Gokhan
authors.initials: G
authors.lastname: Gundogdu
authors.forename: Elcin Hakan
authors.initials: EH
authors.lastname: Terzi
authors.forename: Hulya
authors.initials: H
authors.lastname: Ozturk
authors.forename: Tulin
authors.initials: T
authors.lastname: Firat
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tosun
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis / Q000379:methods; D002245:Carbon Dioxide / Q000008:administration & dosage* / Q000009:adverse effects* / Q000097:blood; D003404:Creatinine / Q000097:blood; D004195:Disease Models, Animal; D007327:Insufflation / Q000009:adverse effects* / Q000379:methods; D011817:Rabbits; D013997:Time Factors; D014508:Urea / Q000097:blood; D014551:Urinary Tract / Q000293:injuries*; D014718:Vesico-Ureteral Reflux / Q000503:physiopathology*
chemical_list: D002245:Carbon Dioxide; D014508:Urea; D003404:Creatinine