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- Title
Carbon dioxide pneumoperitoneum, intraperitoneal pressure, and peritoneal tissue hypoxia: a mouse study with controlled respiratory support.
- Authors
Matsuzaki, Sachiko; Jardon, Kris; Maleysson, Elodie; D'Arpiany, Francis; Canis, Michel; Bazin, Jean-Etienne; Mage, Gérard
- Abstract
Background: Animal experiments have suggested that the laparoscopic peritoneal environment is hypoxic. This study aimed to investigate whether peritoneal tissue is hypoxic on a cellular level during a carbon dioxide (CO) pneumoperitoneum at different intraperitoneal pressures (IPPs) and to determine the short-term effects of surgical injury on the hypoxia status of peritoneal tissue in the injured peritoneum and the distant noninjured peritoneum at cellular and molecular levels. Methods: Experiment 1: Mice were divided into five groups according to the following treatments: anesthesia alone, laparotomy, and CO pneumoperitoneum at IPPs of 2, 8, or 15 mmHg. Over the course of each experiment, the peritoneal tissue-oxygen tension (PitO) was continuously monitored. Experiment 2: On the first day, the mice were divided into three groups according to the following treatments: CO pneumoperitoneum at an IPP of either 2 or 8 mmHg or laparotomy. The bilateral caudal epigastric arteries and uterine horns then were coagulated using a bipolar cautery device. On day 7, peritoneal tissue samples were collected for real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemistry. In both experiments, pimonidazole hydrochloride was used to detect tissue hypoxia at a cellular level. Results: Experiment 1: Peritoneal hypoxia at both tissue and cellular levels was detected only in the groups treated with an IPP of 15 mmHg (PitO: 5.2 ± 1.0 mmHg, mean ± SEM). Experiment 2: The percentage of pimonidazole immunostained mesothelial and stromal cells from the distant noninjured peritoneum was significantly higher in the group treated with an IPP of 8 mmHg than in the other groups. Hypoxia-inducible factor 1 alpha subunit mRNA expression in the distant noninjured peritoneum of the group treated with an IPP of 8 mmHg was significantly higher than in the control group (anesthesia alone). Conclusion: The CO pneumoperitoneum itself did not cause peritoneal hypoxia at either a tissue or a cellular level in a mouse model when a low IPP was used.
- Subjects
ARTIFICIAL pneumoperitoneum; CARBON dioxide; ANIMAL models of pulmonary toxicology; HYPOXEMIA; RESPIRATORY gas monitoring; PERITONEAL access; DISEASE risk factors; THERAPEUTICS
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2010, Vol 24, Issue 11, p2871
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-010-1069-z