Laparoscopic Surgery: Does It Increase the Probability of Atrial and Ventricular Arrhythmias in Children?

Çiftçi, Özgür; Elemen, Levent; Elemen, Funda; Yildirir, Aylin; Çalışkan, Mustafa; Erdoğan, Doğan; Müderrisoğlu, Haldun

doi:10.1097/sle.0b013e3181654470

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…For example, electrocardiograms (ECG) of children undergoing laparoscopic appendectomy showed significant QT dispersion and P-wave depression during CO 2 insufflation (QoE-C4). [19] Although these ECG changes were reversible, it is a cause of concern that they predict severe atrial or ventricular arrhythmias. High intraabdominal pressure of the pneumoperitoneum causes splanchnic ischemia during laparoscopy and reperfusion occurs during deflation of gas.…”

Section: Discussionmentioning

confidence: 99%

Pediatric laparoscopy: Facts and factitious claims

Raveenthiran

2010

J Indian Assoc Pediatr Surg

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Background:Pediatric laparoscopy (LS) is claimed to be superior to open surgery (OS). This review questions the scientific veracity of this assertion by systematic analysis of published evidences comparing LS versus OS in infants and children.Materials and Methods:Search of PubMed data base and the available literature on pediatric LS is analyzed.Results:One hundred and eight articles out of a total of 426 papers were studied in detail.Conclusions:High quality evidences indicate that LS is, at the best, as invasive as OS; and is at the worst, more invasive than conventional surgery. There are no high quality evidences to suggest that LS is minimally invasive, economically profitable and is associated with fewer complications than OS. Evidences are equally distributed for and against the benefits of LS regarding postoperative pain. Proof of cosmetic superiority of LS or otherwise is not available. The author concludes that pediatric laparoscopy, at the best, is simply comparable to laparotomy and its superiority over the latter could not be sustained on the basis of available scientific evidences. Benefits of laparoscopy appear to recede with younger age. Concerns are raised on the quick adoption, undue promotion and frequent misuse of laparoscopy in children.

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Section: Discussionmentioning

confidence: 99%

Pediatric laparoscopy: Facts and factitious claims

Raveenthiran

2010

J Indian Assoc Pediatr Surg

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“…It was also reported, however, that tumor control and surgical time in laparoscopic nephrectomy are not significantly influenced by the approach and that RPL might technically be more challenging because of the smaller working space and port proximity with resulting problematic ergonomy [9,10] . More recent studies have started to emphasize the intraoperative disturbance of cardiovascular and pulmonary functions because interference with the autonomic nervous system via insufflated CO 2 may lead to serious perioperative consequences [11,12] . It is important to decrease intraoperative cardiovascular and pulmonary disturbances.…”

Section: Introductionmentioning

confidence: 99%

Effects of Retroperitoneal or Transperitoneal Laparoscopic Surgery on Hemodynamic and Respiratory Function in Old Patients

Ji¹,

Zhang²,

Li³

et al. 2009

Urol Int

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Purpose: To compare the effects of retroperitoneal laparoscopic surgery (RPL) and transperitoneal laparoscopic surgery (TPL) on the hemodynamic and ventilatory functions in old patients. Methods: Thirty-two senior patients underwent either RPL or TPL. Swan-Ganz and radial artery catheters were placed to monitor hemodynamic functions. Artery blood samples were obtained to analyze ventilatory functions. Results: For hemodynamic changes in both TPL and RPL, central venous pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure significantly increased 10 min after CO₂ insufflation and decreased to preanesthesia levels roughly 30 min after insufflation relief. For ventilatory functions, in both TPL and RPL, peak airway pressure, partial pressure of arterial carbon dioxide (PaCO₂), end-tidal carbon dioxide tension (PetCO₂), carbon dioxide output (VCO₂), and the difference between PaCO₂ and PetCO₂ (Pa-PetCO₂) all increased significantly 10 min after CO₂ insufflation and returned to the preanesthesia level 20 min after CO₂ desufflation. However, increments of PaCO₂, VCO₂ and Pa-PetCO₂ were significantly higher in RPL than in TPL, and did not return to the preanesthesia level until 30 min after CO₂ desufflation. Conclusion: For senior patients, TPL and RPL have similar effects on hemodynamic functions. However, RPL tends to cause much more change in the respiratory measurements.

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Complications of Laparoscopic and Thoracoscopic Surgery

Zallen¹

2008

Complications in Pediatric Surgery

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Laparoscopic Surgery: Does It Increase the Probability of Atrial and Ventricular Arrhythmias in Children?

Abstract: The clinical significance of pneumoperitoneum, which causes an increase in corrected QTD and PWD in children, remains to be determined with further studies.

Cited by 3 publications

References 31 publications

Pediatric laparoscopy: Facts and factitious claims

Pediatric laparoscopy: Facts and factitious claims

Effects of Retroperitoneal or Transperitoneal Laparoscopic Surgery on Hemodynamic and Respiratory Function in Old Patients

Complications of Laparoscopic and Thoracoscopic Surgery

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