Kidney safety during surgical pneumoperitoneum: an experimental study in rats

Barros, Rogério Fortunato de; Miranda, Márcio Lopes; Mattos, Amilcar Castro de; Gontijo, José Antônio Rocha; Silva, Vinícius Rodrigues; Iorio, Brayner; Bustorff‐Silva, Joaquim Murray

doi:10.1007/s00464-012-2322-4

Cited by 11 publications

(8 citation statements)

References 28 publications

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“…In our study, NGAL and IL-18 levels were significantly increased at 12 mmHg insufflation pressure at the 4th hour. In the study of Barros et al, there was no significant difference between NGAL levels of the pneumoperitoneum and control groups (17). This is because they applied 10 mmHg insufflation, which is lower than in our study.…”

Section: Discussioncontrasting

confidence: 76%

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Effectiveness of new parameters in the evaluation of pneumoperitoneum-related acute kidney injury in rats

Kozan¹,

Şare²,

Yılmaz³

et al. 2018

Turk J Med Sci

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Background/aim: Pneumoperitoneum with high pressure results in decreased glomerular filtration rates (GFRs). Cystatin-C (Cys-C), neutrophil gelatinase-associated lipocalin (NGAL), and interleukin 18 (IL-18) are new parameters in the evaluation of GFR instead of creatinine. The aim of this study is to show the effects of pneumoperitoneum on renal function with the help of these new acute kidney injury markers. Materials and methods: Sixty rats were divided into 10 groups according to the length of time and degree of pneumoperitoneum pressure achieved during CO2 insufflation: 0 mmHg (control) for 1 h; 4 mmHg for 1, 2, and 4 h; 8 mmHg for 1, 2, and 4 h; and 12 mmHg for 1, 2, and 4 h. Serum samples were obtained to measure the serum creatinine, blood urea nitrogen (BUN), Cys-C, NGAL, and IL-18. Results: There were no differences between the serum creatinine levels of the groups. Serum levels of BUN, Cys-C, NGAL, and IL-18 were significantly increased in the 2nd hour of the experiment. This increase was more prominent at high pressures. Conclusion: Although serum creatinine is a practical way of estimating GFR, it has been shown that Cys-C, NGAL, and IL-18 are superior in the estimation of decreased GFR in pneumoperitoneum.

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Section: Discussioncontrasting

confidence: 76%

“…We also evaluated the effects of pneumoperitoneum at 60, 120, and 240 min. Attempts at introducing 4-h pneumoperitoneum resulted in the death of rats in previous studies (17). Elevated pressures in renal veins may decrease renal plasma flow and GFR, shunting blood away from the cortex and functioning glomeruli and leading to ischemia.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of new parameters in the evaluation of pneumoperitoneum-related acute kidney injury in rats

Kozan¹,

Şare²,

Yılmaz³

et al. 2018

Turk J Med Sci

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“…No difference was reported in the renal expression of NGAL after 1 and 2 hours of pneumoperitoneum. 29 In support of this result, we also did not detect a significant difference in uNGAL levels when surgery was longer than 60 min. NGAL is an accurate method for facilitating the early detection of kidney damage.…”

Section: Discussionsupporting

confidence: 76%

Neutrophil Gelatinase-Associated Lipocalin Levels During Pneumoperitoneum

Kiseli

Çağlar

Yılmaz

et al. 2017

JSLS

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Background and Objectives:A temporary deterioration in renal function during pneumoperitoneum has been reported, but the extent is not known. A new marker for the early detection of renal injury, neutrophil gelatinase-associated lipocalin (NGAL), has been shown to increase in various conditions that affect renal function. This study was conducted to explore detrimental effects of pneumoperitoneum in laparoscopic surgery on renal function by studying levels of urinary NGAL (uNGAL).Methods:Thirty-two women scheduled to undergo laparoscopic surgery in a gynecology clinic were recruited. NGAL was measured in urine collected at the beginning (0 h) and at 2 and 24 hours after the initiation of surgery. Hemodynamic parameters were analyzed immediately after intubation and before desufflation.Results:Levels of uNGAL increased from 5.45 ng/mL at 0 hours to 6.35 ng/mL at 2 hours and to 6.05 ng/mL at 24 h; however, there was no significant change in uNGAL levels at the collection time points. Intraoperative oliguria was observed in all cases, and the severity increased with the duration of surgery. uNGAL levels did not correlate with the duration of surgery or pneumoperitoneum.Conclusion:In patients with normal renal functions, pneumoperitoneum results in transient oliguria without any early renal damage, as indicated by nonsignificant changes in uNGAL levels.

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“…Increases in ischemia and the oxidative stress response have been observed with pneumoperitoneum-dependent impairment of organ perfusion. Following desufflation, reperfusion injury occurred with a decrease in intraabdominal pressure (8,9).…”

Section: Introductionmentioning

confidence: 99%

Oxidative damage and mitochondrial injuries differ following pneumoperitoneum pressure in rabbit models of varying degrees of hydronephrosis

Zhao

Rao

et al. 2018

Mol Med Report

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The influence of intraabdominal pressure which is necessary to maintain the operating area during the surgery cannot be ignored especially on the kidneys. Many articles have reported the effect of intraabdominal pressure on normal kidneys. However, the influence of intraabdominal pressure on hydronephrosis kidneys is rarely studied. The aim of the present study was to clarify whether intraabdominal pressure tolerance is modified in various degrees of kidney hydronephrosis by evaluating oxidative damage and mitochondrial injuries. A total of 72 rabbits were randomly divided into three groups (groups N, M and S, which represented rabbits with no, mild and severe hydronephrosis, respectively). Rabbits in groups M (n=24) and S (n=24) underwent a surgical procedure inducing mild or severe hydronephrosis, respectively. Subsequently, rabbits in all groups were allocated to 4 subgroups (N0‑N3, M0‑M3 and S0‑S3) consisting of 6 rabbits each. Groups 0 to 3 were, respectively, subjected to intraabdominal pressures of 0, 5, 10 and 15 mmHg. Oxidative damage was assessed by analyzing levels of reactive oxygen species (ROS), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH‑Px), catalase (CAT) and lactate (LD). Mitochondrial injuries were assessed based on mitochondrial membrane potential (MMP) alterations, mitochondrial structure and cytochrome c (cytc) protein expression, as measured by JC‑1 staining, electron microscopy and western blotting, respectively. Oxidative damage and mitochondrial injuries were noticeably exacerbated in group N and M with increased levels of ROS, MDA and LD, decreased levels of SOD, GSH‑Px, CAT and MMP, mitochondrial vacuolization and higher expression of cytc when the intraabdominal pressure reached 15 mmHg. In group S, these alterations occurred at pressures of 10 and 15 mmHg. Therefore, it was concluded that in rabbits exposed to pneumoperitoneal pressure, kidneys with severe hydronephrosis were more likely to suffer from oxidative damage and mitochondrial injuries compared with kidneys with mild hydronephrosis and normal kidneys.

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Kidney safety during surgical pneumoperitoneum: an experimental study in rats

Abstract: Under the experimental conditions of this study, the animals with normal preoperative renal function did not show any type of acute kidney injury associated with the presence of a stabilized surgical pneumoperitoneum.

Cited by 11 publications

References 28 publications

Effectiveness of new parameters in the evaluation of pneumoperitoneum-related acute kidney injury in rats

Effectiveness of new parameters in the evaluation of pneumoperitoneum-related acute kidney injury in rats

Neutrophil Gelatinase-Associated Lipocalin Levels During Pneumoperitoneum

Oxidative damage and mitochondrial injuries differ following pneumoperitoneum pressure in rabbit models of varying degrees of hydronephrosis

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