Turk J Med Sci. 2019 Apr 18;49(2):639-643. doi: 10.3906/sag-1803-176.
BACKGROUND/AIM: Intraabdominal pressure (IAP) is one of the main reasons for gastroesophageal reflux (GER). This study investigates whether IAP during laparoscopic surgery leads to GER in a time-dependent manner.
In a laparoscopy model, 15 mmHg IAP was created in 8 Wistar albino rats in the Trendelenburg position (TP). A 5 mm laparotomy was performed in the left lower abdominal region, and a 6 Fr catheter was placed intraabdominally. Air was insufflated into the abdominal cavity, and the pressure was kept constant at 15 mmHg. Esophageal pH alterations were measured by pH sticks for 4 h every 30 min.
The basal median esophageal pH value was 9 (8–10), the value after placing the catheter was 9 (7–10) (P = 0.47), and the median pH value after placing the subjects in TP was 9 (8–10) (P = 0.70). In our experimental model, esophageal pH values were found to decrease significantly at the 150th minute in TP and at 15 mmHg IAP (P < 0.05). Two rats died: one at the 120th minute and the other at the 240th minute (P > 0.05)
Esophageal pH values decreased and continued to remain low following IAP increase and TP in this experimental rat model. Prolonged laparoscopic procedures can particularly lead to GER that requires instant recognition and rapid and appropriate intervention.
背景/目的：腹腔内压（IAP）是胃食管反流（GER）的主要原因之一。本研究旨在探讨腹腔镜手术期间 IAP 是否会导致 GER 发生时间依赖性变化。
在腹腔镜模型中，将 15mmHg IAP 施加于 8 只 Wistar 白化大鼠，使其处于头高脚低位（TP）。在左下腹区域进行 5mm 剖腹术，并将 6Fr 导管置于腹腔内。向腹腔内注入空气，将压力保持在 15mmHg 不变。每隔 30 分钟使用 pH 棒测量 4 小时的食管 pH 变化。
基础中位食管 pH 值为 9（8-10），放置导管后为 9（7-10）（P=0.47），将受试动物置于 TP 后中位 pH 值为 9（8-10）（P=0.70）。在我们的实验模型中，在 TP 和 15mmHg IAP 下，食管 pH 值在第 150 分钟时显著降低（P<0.05）。两只大鼠死亡：一只在第 120 分钟死亡，另一只在第 240 分钟死亡（P>0.05）。
在这个实验性大鼠模型中，随着 IAP 增加和 TP，食管 pH 值下降并持续保持低值。长时间的腹腔镜手术可能特别导致 GER，需要及时识别并迅速采取适当的干预措施。
