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Article Dans Une Revue Scientific Reports Année : 2017

Effects of low intraperitoneal pressure and a warmed, humidified carbon dioxide gas in laparoscopic surgery: a randomized clinical trial

Lise Vernis
  • Fonction : Auteur
Martine Bonnin
  • Fonction : Auteur
Celine Houlle
  • Fonction : Auteur
Aurelie Fournet-Fayard
  • Fonction : Auteur
Giuseppe Rosano
  • Fonction : Auteur
Anne Laure Lafaye
  • Fonction : Auteur
Christian Chartier
  • Fonction : Auteur
Agnes Barriere
  • Fonction : Auteur
Brigitte Storme
  • Fonction : Auteur

Résumé

Laparoscopic surgery technology continues to advance. However, much less attention has been focused on how alteration of the laparoscopic surgical environment might improve clinical outcomes. We conducted a randomized, 2 × 2 factorial trial to evaluate whether low intraperitoneal pressure (IPP) (8 mmHg) and/or warmed, humidified CO 2 (WH) gas are better for minimizing the adverse impact of a CO 2 pneumoperitoneum on the peritoneal environment during laparoscopic surgery and for improving clinical outcomes compared to the standard IPP (12 mmHg) and/or cool and dry CO 2 (CD) gas. Herein we show that low IPP and WH gas may decrease inflammation in the laparoscopic surgical environment, resulting in better clinical outcomes. Low IPP and/or WH gas significantly lowered expression of inflammation-related genes in peritoneal tissues compared to the standard IPP and/or CD gas. The odds ratios of a visual analogue scale (VAS) pain score >30 in the ward was 0.18 (95% CI: 0.06, 0.52) at 12 hours and 0.06 (95% CI: 0.01, 0.26) at 24 hours in the low IPP group versus the standard IPP group, and 0.16 (95% CI: 0.05, 0.49) at 0 hours and 0.29 (95% CI: 0.10, 0.79) at 12 hours in the WH gas group versus the CD gas group.
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Dates et versions

hal-01655196 , version 1 (28-02-2019)

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Sachiko Matsuzaki, Lise Vernis, Martine Bonnin, Celine Houlle, Aurelie Fournet-Fayard, et al.. Effects of low intraperitoneal pressure and a warmed, humidified carbon dioxide gas in laparoscopic surgery: a randomized clinical trial. Scientific Reports, 2017, 7 (1), ⟨10.1038/s41598-017-10769-1⟩. ⟨hal-01655196⟩
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