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Surgical Endoscopy

Published in:

01-05-2011

Effects of CO₂ insufflation on cerebrum during endoscopic thyroidectomy in a porcine model

Authors: Wenbin Yu, Feng Li, Zhigang Wang, Xiaoliang Qi, Bo Li, Guangyong Zhang, Xiaoguang Hao, Sanyuan Hu

Published in: Surgical Endoscopy | Issue 5/2011

Abstract

Background

The operative cavity during endoscopic thyroidectomy is maintained mainly by CO₂ insufflation. We designed this study to explore the effects of CO₂ insufflation on the cerebrum during endoscopic thyroidectomy in a porcine model.

Methods

Twelve Chinese minipigs were randomly divided into four groups. Group A underwent traditional thyroidectomy and served as the control group. Groups B, C, and D underwent endoscopic thyroidectomy at CO₂ pressures of 5, 10, and 15 mmHg, respectively. Arterial partial pressure of CO₂ (PaCO₂), pH, and intracranial pressure (ICP) were measured at five time points. Cerebral tissue was removed and evaluated pathologically and by transmission electron microscopy (TEM).

Results

There were no statistical differences between group A and group B in all measured values. PaCO₂ increased and pH decreased gradually, while ICP did not change significantly in Group C. In Group D, PaCO₂ increased and pH decreased gradually, while ICP increased significantly. In Groups C and D, cerebral edema appeared obviously and the quantity of glial cells increased significantly compared with that in Groups A and B. The ultrastructures of neurons and glial cells changed apparently, accompanied by increasing apoptosis in Groups C and D as seen by TEM.

Conclusion

Lengthy CO₂ insufflation at high pressure (15 mmHg) caused an increase in ICP and cerebral edema during endoscopic thyroidectomy. It even caused cerebral edema at 10 mmHg in spite of no increase in ICP. Therefore, we suggest that the pressure of CO₂ insufflation should be lower than 10 mmHg, and that 5 mmHg is the relatively safe and recommended pressure.

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Title: Effects of CO2 insufflation on cerebrum during endoscopic thyroidectomy in a porcine model
Authors: Wenbin Yu
Feng Li
Zhigang Wang
Xiaoliang Qi
Bo Li
Guangyong Zhang
Xiaoguang Hao
Sanyuan Hu
Publication date: 01-05-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 5/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-010-1425-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of CO₂ insufflation on cerebrum during endoscopic thyroidectomy in a porcine model

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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