Bilgic Tayfun, Narter Fehmi
Department of General Surgery, Acibadem Kadikoy Hospital, Istanbul, Turkey.
Department of Urology, Acibadem Mehmet Ali Aydinlar University, Kadikoy Hospital, Istanbul, Turkey.
Wideochir Inne Tech Maloinwazyjne. 2020 Dec;15(4):574-582. doi: 10.5114/wiitm.2020.93990. Epub 2020 Mar 27.
Laparoscopic surgery is a preferred method based on its many benefits. However, increasing abdominal pressure by CO insufflation during the implementation of this technique poses challenges.
To determine the degree of renal and liver injury that occurs in a pneumoperitoneum (PP) model of prolonged CO insufflation.
Twenty-one female Sprague Dawley rats were separated randomly into three groups. Group 1 was the control group and given anesthesia for 3 h. In group 2, PP was administered under anesthesia for 1 h. In the last group, PP was administered under anesthesia to animals for 3 h. We measured renal and liver injury biomarkers and made a histopathological evaluation to estimate the degree of injury and assessed the correlation of biomarkers including kidney injury molecule-1 (KIM-1) with histopathological findings.
Histopathological analysis according to the kidney ischemia tubular damage score showed a statistically significant difference between the 3 groups (p < 0.001). There was an increase in KIM-1 levels in the groups, although it was not statistically significant (p = 0.062, p = 0.156, p = 0.350 respectively). According to the correlation test in this research, KIM-1 results had a statistically significant association with creatinine, urea, aspartate aminotransferase and alanine aminotransferase levels in all control and study groups.
According to our results, the increase in KIM-1 was correlated with Cr levels and compatible with histopathological analysis. Moreover, intra-abdominal pressure statistically significantly increased the degree of kidney injury and there was not a significant increase in the levels of KIM-1. There was no difference in liver damage between groups.
腹腔镜手术因其诸多优点而成为首选方法。然而,在实施该技术过程中,通过二氧化碳气腹增加腹腔压力带来了挑战。
确定长时间二氧化碳气腹(PP)模型中发生的肾和肝损伤程度。
将21只雌性Sprague Dawley大鼠随机分为三组。第一组为对照组,给予3小时麻醉。第二组在麻醉下进行1小时气腹。最后一组在麻醉下对动物进行3小时气腹。我们测量了肾和肝损伤生物标志物,并进行组织病理学评估以估计损伤程度,评估包括肾损伤分子-1(KIM-1)在内的生物标志物与组织病理学结果的相关性。
根据肾脏缺血性肾小管损伤评分进行的组织病理学分析显示,三组之间存在统计学显著差异(p < 0.001)。各组KIM-1水平均有升高,尽管无统计学显著性(分别为p = 0.062、p = 0.156、p = 0.350)。根据本研究中的相关性检验,在所有对照组和研究组中,KIM-1结果与肌酐、尿素、天冬氨酸转氨酶和丙氨酸转氨酶水平存在统计学显著关联。
根据我们的结果,KIM-1的升高与肌酐水平相关,且与组织病理学分析结果相符。此外,腹内压在统计学上显著增加了肾损伤程度,而KIM-1水平无显著升高。各组之间肝损伤无差异。