Prima Ciko1, Fina Widia2, Agus Rizal A H Hamid2, Irfan Wahyudi2, Chaidir A Mochtar2. 1. Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Electronic address: primacikoadeputra@gmail.com. 2. Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Abstract
INTRODUCTION: The use of low-pressure pneumoperitoneum during laparoscopic living donor nephrectomy (LLDN) was assumed to cause less renal damage compared to high-pressure pneumoperitoneum. This study aims to evaluate the effect of low vs high-pressure pneumoperitoneum during LLDN on renal function and renal resistive index (RRI), which has never been done before. MATERIALS AND METHODS: The subjects were divided into 2 groups, low-pressure (8-10 mmHg) and high-pressure pneumoperitoneum (12-14 mmHg). The RRI, serum creatinine, and estimated glomerular filtration rate were measured during the perioperative period. RESULTS: A total of 45 samples were analyzed in this study: 17 subjects in the low-pressure pneumoperitoneum group and 28 subjects in the high-pressure group. RRI levels remained within the normal range (< .80) with no significant difference observed between the 2 groups (P > .05) before surgery, intraoperatively, or post-surgery. The preoperative and postoperative serum creatinine and glomerular filtration rate were similar in both groups. CONCLUSIONS: The use of low-pressure pneumoperitoneum had no benefit compared to high-pressure pneumoperitoneum in preserving RRI and function in LLDN.
INTRODUCTION: The use of low-pressure pneumoperitoneum during laparoscopic living donor nephrectomy (LLDN) was assumed to cause less renal damage compared to high-pressure pneumoperitoneum. This study aims to evaluate the effect of low vs high-pressure pneumoperitoneum during LLDN on renal function and renal resistive index (RRI), which has never been done before. MATERIALS AND METHODS: The subjects were divided into 2 groups, low-pressure (8-10 mmHg) and high-pressure pneumoperitoneum (12-14 mmHg). The RRI, serum creatinine, and estimated glomerular filtration rate were measured during the perioperative period. RESULTS: A total of 45 samples were analyzed in this study: 17 subjects in the low-pressure pneumoperitoneum group and 28 subjects in the high-pressure group. RRI levels remained within the normal range (< .80) with no significant difference observed between the 2 groups (P > .05) before surgery, intraoperatively, or post-surgery. The preoperative and postoperative serum creatinine and glomerular filtration rate were similar in both groups. CONCLUSIONS: The use of low-pressure pneumoperitoneum had no benefit compared to high-pressure pneumoperitoneum in preserving RRI and function in LLDN.
Authors: Alexander West; John Hayes; Darryl Ethan Bernstein; Mahesh Krishnamoorthy; Steven Lathers; Gary Tegan; Jeremy Teoh; Prokar Dasgupta; Karel Decaestecker; Nikhil Vasdev Journal: J Robot Surg Date: 2022-01-30