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Evaluation of renal oxygenization in laparoscopic pediatric surgery by near infrared spectroscopy

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Abstract

Purpose

Increased intraabdominal pressure IAP may reduce renal blood flow (RBF). The study aims to evaluate the pneumoperitoneum effect on RBF by comparing renal regional oxygen saturation index (rSrO2) measured by near-infrared spectroscopy (NIRS) in pediatric patients having laparotomy and laparoscopy.

Methods

Of 58 patients having laparoscopy and laparotomy, 18 were excluded due to renal pathologies, combined open surgical procedures, and administration of inotropic drugs. Hemodynamic parameters and rSrO2 were recorded in laparoscopy (n = 20) and laparotomy (n = 20) groups before induction and with 5 min intervals up to 60 min and at post-extubation.

Results

Decrease in right renal rSrO2 at 45th and 60th min and 30th, 45th and 60th min in left were significant in the laparoscopy group compared to laparotomy group. In the laparoscopy group, reductions at T25, T30, T45, and T60 were significant in both renal rSrO2. Renal rSO2 increased to normal with desufflation.

Conclusion

IAP with pneumoperitoneum may lead to renal hypoxia in children. Renal rSO2 returns to normal with desufflation. Renal NIRS monitorization might be needed in patients with renal parenchymal and vascular pathologies, solitary kidney, and multiorgan pathologies that may affect renal oxygenation.

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Author notes

    Authors and Affiliations

    1. Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey

      Emine Çalışkan, Sema Şanal Baş, Meryem Onay, Yeliz Kılıç & Gülay Kayhan Erdoğan

    2. Department of Pediatric Surgery, Eskisehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey

      Baran Tokar

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    1. Emine Çalışkan
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    Correspondence to Sema Şanal Baş.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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    It was obtained from all individual participants included in the study.

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    Emine Çalışkan and Sema Şanal Baş contributed equally to this study.

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    Çalışkan, E., Şanal Baş, S., Onay, M. et al. Evaluation of renal oxygenization in laparoscopic pediatric surgery by near infrared spectroscopy. Pediatr Surg Int 36, 1077–1086 (2020). https://doi.org/10.1007/s00383-020-04709-w

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    • DOI: https://doi.org/10.1007/s00383-020-04709-w

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