title: Pneumoperitoneum and hemodynamic stability during pediatric laparoscopic appendectomy.
abstract: 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.
  
  
  CONCLUSIONS
  Because IPP was significantly lower during LA with AiFS, EtCO2and BP were significantly lower.
  
  
  METHODS
  Treatment study; prospective comparative study - level II.
authors.affiliation: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: go1993@hotmail.co.jp.
authors.forename: Go
authors.initials: G
authors.lastname: Miyano
authors.affiliation: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Seo
authors.affiliation: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Sueyoshi
authors.affiliation: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Okawada
authors.affiliation: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Doi
authors.affiliation: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koga
authors.affiliation: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Lane
authors.affiliation: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Yamataka
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000503:physiopathology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007327:Insufflation; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011028:Pneumoperitoneum, Artificial; D011446:Prospective Studies
keywords: Hemodynamics; Laparoscopic appendectomy; Pneumoperitoneum