Oxygenation change of the abdominal organs at laparoscopy surgeries in various gaseous media
Objectives. To study the impact of carbon dioxide and synthetic air insufflated to the abdominal cavity on the respiratory activity of the abdominal cavity organs of patients undergoing laparoscopic cholecystectomy. Methods. Two groups of patients (62 patients in each group) with calculous cholecystitis were included in the investigation. To create a working space for the laparoscopic procedures in the first group carbon dioxide was used; in the second - synthetic air. Investigation of the influence of gases on the internal organs oxygenation (liver, peritoneum and small intestine) was studied by the direct oximetry at the beginning of the operation (after setting the ports), insufflation of gas at the end of surgery prior to the removal of the tools. Results. On insufflation of carbon dioxide the oxygen utilization rate by the peritoneum increased from 198,5 to 264,9 mm Hg/min, at the same time the oxygen content in it 2 times decreased from 125,4 to 64,2 mm Hg. The tissue respiration rate in the intestinal wall increased from 347,3 to 549,5 mm Hg/min and oxygen partial pressure increased from 121,9 to 144,7 mm Hg. The tissue respiration rate in the liver decreased from 215,8 to 73,4 mm Hg/min, and oxygen partial pressure increased from 74,3 to 132,3 mm Hg. While using the air gaseous mixture, statistically significant differences between the findings obtained at the beginning and at the end of the operation were not revealed. Conclusions. The obtained data suggest that the peritoneum is easily permeable both to carbon dioxide and oxygen; in consequence of this the use of carbon dioxide markedly inhibits the oxygenation of the border tissue and causes acidemia. The air gaseous mixture has no significant effect on the respiratory activity of the organs and tissues.