Karbondioksit ile Oluşturulan Pnömoperitoneumun Periton Yapısı Üzerine Etkileri

Yıl 2017, , 45 - 49, 14.04.2017

Bekir Sarıcık , Yavuz Savaş Koca , Ömer Rıdvan Tarhan

https://doi.org/10.22312/sdusbed.297916

Öz

Giriş :  Laparoskopik
ameliyatların uygulanmaya başlamasıyla beraber pnömoperiton oluşturmak için
birçok gaz denenmiştir.  Bunlar arasında
halen  en yaygın kullanımda olan
karbondioksit gazıdır.  karbondioksit ile
oluşturulan pnömoperiton  laparoskopik
ameliyatlarda cerrahlara uygun alan oluşturmasına rağmen   peritoneal yapı üzerinde birtakım istenmeyen  değişikliklere de sebep olmaktadır. Bu yan
etkilerden bazıları kaçınılmaz olmasına rağmen bazı yan etkilerde uygulama
şekline bağlı değişiklik gösterebilmektedir .

Metod:  Karbondioksit ile oluşturulan pnömoperitonun
peritoneal yapı üzerine etkilerine ilişkin  literatürdeki yapılan deneysel ve klinik çalışmalar
dikkate alınarak bu derleme hazırlandı.

Sonuçlar : Pnomöperiton oluşumu peritoneal
çevreyi ve dolayısıyla organizmayı etkiler. Bu etkilenim intraabdominal basınç
artışı, karbondioksitin lokal peritoneal destrüktif etkileri, karbondioksit
emilimi ve kimyasal metabolik  değişimler
gibi sebeplerle olmaktadır.  İnsuflasyon
hızı ve basıncı genel olarak hemodinamik değişiklikler yapmaktadır.
Karbondioksitin hipoksiketkisi, 
toksik  etkisi, kuruluğu,soğukluğu
peritoneal çevrenin yapısal bozulmasına sebep olmaktadır.

Tartışma : laparoskopik cerrahi hergeçen gün
daha da yaygınlaşmaktadır. Bu ndenle özellikle ek hastalığı olan ya da obez
hastalarda pnömoperitonun yaptığı etkiler hakkında farkındalığa sahip olunması
önemlidir. Bu farkındalık hastaların pnömoperitonun yaptığı istenmeyen
değişikliklerden etkilenimini azaltacağı kanısındayız.

Anahtar Kelimeler

karbondioksit pnömoperitoneum, laparoskopi, karbondioksit insuflasyon

The Effects of Carbon Dioxide Pneumoperitoneum on Peritoneal Structure

Öz

Background: 
To create pneumoperitoneum at the beginning of laparoscopic surgery,
several gases have been trialled. The most commonly used of these gases is
carbon dioxide. Although pneumoperitoneum created with carbon dioxide provides
an appropriate area for surgeons to perform laparoscopic operations, it can
also cause several unwanted changes to the peritoneal structure. Some of these
side-effects are inevitable but some exhibit changes depending on the method of
application.

Methods: 
This review was prepared taking into consideration the previous
experimental and clinical studies in literature related to the effects on the
peritoneal structure of pneumoperitoneum created with carbon dioxide.

Results: The creation of pneumoperitoneum
affects the peritoneal environment and thereby the organism. This effect is
caused by increased intra-abdominal pressure, the local peritoneal destructive
effect, carbon dioxide absorption and chemical metabolic changes. The
insufflation rate and pressure generally make haemodynamic changes. The hypoxic
effect of carbon dioxide, the toxic effect, the dryness and the coldness may
cause structural impairment of the peritoneal environment.

Conclusions: Laparoscopic surgery is becoming more widespread.
Therefore, it is important to be aware of the effects created by
pneumoperitoneum, especially in obese patients or those with concomitant
diseases. With this awareness, it will be possible to reduce the effects of the
undesired changes wrought by pneumoperitoneum. 

Anahtar Kelimeler

Carbon dioxide pneumoperitoneum, laparoscopy, , carbon dioxide insufflation

Kaynakça

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