CHARACTERISTICS OF THE FUNCTIONAL STATE OF SMALL-CALIBER ARTERIES UNDER THE INFLUENCE OF PNEUMOPERITONEUM OF VARIOUS DURATION AND SIMULATED MECHANICAL JAUNDICE IN THE EXPERIMENT
DOI:
https://doi.org/10.11603/2414-4533.2025.3.15671Keywords:
morphology, muscle tissue, jaundice, intra-abdominal pressure, rats, experimentAbstract
The aim of the work: to conduct a morphometric analysis of the features of changes in the indicators of small-caliber arteries of the diaphragm under conditions of pneumoperitoneum with intra-abdominal pressure of 10 mmHg of different duration during simulated mechanical jaundice.
Materials and Methods. For the experimental study, sexually mature white rats of the reproductive period (6–7 months), weighing (225.0±15.0) grams, in a total of 55 individuals, were selected. The animals were divided into 4 groups: control – individuals with mechanical jaundice; and three experimental groups where jaundice and pneumoperitoneum were simulated for 1, 2 and 3 hours according to the group number. At the end of the experiment, the diaphragm was isolated and morphometric indicators were determined.
Results. As a result of the action of the simulated pathological processes, an increase in the indicators of the external diameter of the artery from 5.9 to 6.7 %, a decrease in the internal diameter of the vessel from 24.6 to 25.4 % was observed. The Wogenvoord index increased by 2.1 times, while the thickness of the media naturally increased from 17.1 to 18.7 %. Changes in these indicators indicated a violation of the blood supply to the organ, a sharp decrease in the throughput of vessels of this type. The indicators of the height of endothelial cells and the diameter of their nuclei decreased, but no statistically significant difference was found. The relative volume of damaged endothelial cells increased significantly from (3.32±0.24) % to (29.50±0.21) % in the costal part of the diaphragm and from (4.03±0.11) % to (30.70±0.14) % in the lumbar part, which indicated signs of endothelial dysfunction. These changes should be taken into account in the clinical practice of doctors in surgical departments, where laparoscopic surgical interventions are common, for a better understanding of the impact of pneumoperitoneum on the human body and the diaphragm in particular, which plays an important role in the act of breathing and pulmonary excursion.
Conclusions. The results obtained indicate that pneumoperitoneum created by carbon dioxide leads to changes in the morphometric parameters of small-caliber arteries, which are directly proportional to the duration of the latter.
References
Song G, Jiang Y, Liu Q, Lin H, Qin J. CO2 pneumoperitoneum pressure: an important factor influenced ovarian function after laparoscopy. Ann Palliat Med. 2021; 10(8):9326-27. DOI: 10.21037/apm-2021-05. Epub 2021 Jul 20. PMID: 34328008. DOI: https://doi.org/10.21037/apm-2021-05
Reijnders-Boerboom GTJA, Albers KI, Jacobs LMC, Helden EV, Rosman C, Díaz-Cambronero O, Mazzinari G, Scheffer GJ, Keijzer C, Warlé MC. Low intra-abdominal pressure in laparoscopic surgery: a systematic review and meta-analysis. Int J Surg. 2023;1 09(5):1400-11. DOI: 10.1097/JS9.0000000000000289. PMID: 37026807; PMCID: PMC10389627. DOI: https://doi.org/10.1097/JS9.0000000000000289
Ott DE. Abdominal Compliance and Laparoscopy: A Review. JSLS. 2019; 23(1):e2018.00080. DOI: 10.4293/JSLS.2018.00080. PMID: 30828242; PMCID: PMC6383692. DOI: https://doi.org/10.4293/JSLS.2018.00080
Sterke F, van Weteringen W, Ventura L, Milesi I, Wijnen RMH, Vlot J, Dellacà RL. A novel method for monitoring abdominal compliance to optimize insufflation pressure during laparoscopy. Surg Endosc. 2022; 36(9):7066-74. DOI: 10.1007/s00464-022-09406-4. Epub 2022 Jul 21. PMID: 35864355; PMCID: PMC9402757. DOI: https://doi.org/10.1007/s00464-022-09406-4
Qi F, Wang B, Fei F, Guo Q, Zheng Z, Yang G, Li K. Impact of pneumoperitoneum pressure on cardiac output in laparoscopic surgery. BMC Anesthesiol. 2025; 25(1):317. DOI: 10.1186/s12871-025-03111-0. PMID: 40596831; PMCID: PMC12211448. DOI: https://doi.org/10.1186/s12871-025-03111-0
Laskov I, Alpern S, Ronel I, Segal R, Zindel O, Zoborovsky I, Michaan N, Grisaru D. Cardiac Function and Hemodynamic Changes during Minimally Invasive Hysterectomy with Pneumoperitoneum and Steep Trendelenburg Position for Patients with Endometrial Cancer Who Are Obese. J Minim Invasive Gynecol. 2021 May; 28(5):1079-85. DOI: 10.1016/j.jmig.2020.10.005. Epub 2020 Oct 14. PMID: 33065261. DOI: https://doi.org/10.1016/j.jmig.2020.10.005
Wise R, Rodseth R, Párraga-Ros E, Latorre R, López Albors O, Correa-Martín L, M Sánchez-Margallo F, Eugenia Candanosa-Aranda I, Poelaert J, Castellanos G, Malbrain MLNG. The pathophysiological impact of intra-abdominal hypertension in pigs. PLoS One. 2023; 18(8):e0290451. DOI: 10.1371/journal.pone.0290451. PMID: 37639437; PMCID: PMC10461824. DOI: https://doi.org/10.1371/journal.pone.0290451
Skytioti M, Elstad M, Søvik S. Internal Carotid Artery Blood Flow Response to Anesthesia, Pneumoperitoneum, and Head-up Tilt during Laparoscopic Cholecystectomy. Anesthesiology. 2019; 131(3):512-20. DOI: 10.1097/ALN.0000000000002838. PMID: 31261258. DOI: https://doi.org/10.1097/ALN.0000000000002838
Sterke F, van Weteringen W, van der Zee PA, van Rosmalen J, Wijnen RMH, Vlot J. Surgical conditions in experimental laparoscopy: effects of pressure, neuromuscular blockade, and pre-stretching on workspace volume. Surg Endosc. 2024; 38(12):7426-34. DOI: 10.1007/s00464-024-11338-0. Epub. 2024 Oct. 24. PMID: 39448406; PMCID: PMC11614944. DOI: https://doi.org/10.1007/s00464-024-11338-0
Chen HL, Wu SH, Hsu SH, Liou BY, Chen HL, Chang MH. Jaundice revisited: recent advances in the diagnosis and treatment of inherited cholestatic liver diseases. J Biomed Sci. 2018; 25(1):75. DOI: 10.1186/s12929-018-0475-8. PMID: 30367658; PMCID: PMC6203212. DOI: https://doi.org/10.1186/s12929-018-0475-8
Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int. 2018; 17(1):17-21. DOI: 10.1016/j.hbpd.2018.01.008. Epub 2018 Jan 31. PMID: 29428098. DOI: https://doi.org/10.1016/j.hbpd.2018.01.008
Kaya O, Koca YS, Barut İ, Baspinar S, Sabuncuoglu MZ. L-carnitine reduces acute lung injury in experimental biliary obstruction. Saudi Med J. 2015; 36(9):1046-52. DOI: 10.15537/smj.2015.9.12206. PMID: 26318460; PMCID: PMC4613627. DOI: https://doi.org/10.15537/smj.2015.9.12206
Zhang CX, Shu CM, Zhang XY, Lin XT, Guan QH, Zhang F, Zhi XT. Effect and mechanism of omega-3 polyunsaturated fatty acids on intestinal injury in rats with obstructive jaundice. Eur Rev Med Pharmacol Sci. 2021; 25(19):6077-92. DOI: 10.26355/eurrev_202110_26886. PMID: 34661268.
Chen J, Dong JT, Li XJ, Gu Y, Cheng ZJ, Cai YK. Glucagon-like peptide-2 protects impaired intestinal mucosal barriers in obstructive jaundice rats. World J Gastroenterol. 2015; 21(2):484-90. DOI: 10.3748/wjg.v21.i2.484. PMID: 25593463; PMCID: PMC4292279. DOI: https://doi.org/10.3748/wjg.v21.i2.484
Demircioglu MK, Demircioglu ZG, Cakir O, Yanar K, Ozguven MBY, Atukeren P, Gulcicek OB, Citgez B, Yazici P. Antioxidant effect of Rosa pimpinellifolia L. fruit extract on cholestatic liver injury: an experimental study. Rev Assoc Med Bras. 2024; 70(1):e20230720. DOI: 10.1590/1806-9282.20230720. PMID: 38198394; PMCID: PMC10768672. DOI: https://doi.org/10.1590/1806-9282.20230720
Shen X, Zhang X, Li K, Huang G, Li X, Hou Y, Ge X. Combined bacterial translocation and cholestasis aggravates liver injury by activation pyroptosis in obstructive jaundice. Heliyon. 2024; 10(16):e35793. DOI: 10.1016/j.heliyon.2024.e35793. PMID: 39220957; PMCID: PMC11363856. DOI: https://doi.org/10.1016/j.heliyon.2024.e35793
Lessa TB, de Abreu DK, Bertassoli BM, Ambrósio CE. Diaphragm: A vital respiratory muscle in mammals. Ann Anat. 2016; 205:122-7. DOI: 10.1016/j.aanat.2016.03.008. Epub 2016 Apr 1. PMID: 27045597. DOI: https://doi.org/10.1016/j.aanat.2016.03.008
Kocjan J, Adamek M, Gzik-Zroska B, Czyżewski D, Rydel M. Network of breathing. Multifunctional role of the diaphragm: a review. Adv Respir Med. 2017; 85(4):224-32. DOI: 10.5603/ARM.2017.0037. PMID: 28871591. DOI: https://doi.org/10.5603/ARM.2017.0037
Kritsak MY, Dzyubanovsky IY, Golovata TK, Gargula TI, Yasinovskyi OB, Palamar SA. Structural changes in the diaphragm under conditions of obstructive jaundice (an experimental study). Rep. of Morph. 2025; 31(1):22-9. DOI: 10.31393/morphology-journal-2025-31(1)-03. DOI: https://doi.org/10.31393/morphology-journal-2025-31(1)-03
Kritsak MY, Gargula TI, Slabyi OB, Yasinovskyi OB, Kuziv OV, Ihnatishchev MR. Characteristics of morphological changes in the lumbar part of the diaphragm in cases of obstructive jaundice and pneumoperitoneum. Arch Balk Med Union. 2025; 60(1):62-8. DOI: 10.31688/ABMU.2025.60.1.06. DOI: https://doi.org/10.31688/ABMU.2025.60.1.06
de Lacy FB, Taurà P, Arroyave MC, Trépanier JS, Ríos J, Bravo R, Ibarzabal A, Pena R, Deulofeu R, Lacy AM. Impact of pneumoperitoneum on intra-abdominal microcirculation blood flow: an experimental randomized controlled study of two insufflator models during transanal total mesorectal excision : An experimental randomized multi-arm trial with parallel treatment design. Surg Endosc. 2020; 34(10):4494-03. DOI: 10.1007/s00464-019-07236-5. Epub. 2019 Nov. 7. PMID: 31701284. DOI: https://doi.org/10.1007/s00464-019-07236-5
He H, Gruartmoner G, Ince Y, van Berge Henegouwen MI, Gisbertz SS, Geerts BF, Ince C, Hollmann MW, Liu D, Veelo DP. Effect of pneumoperitoneum and steep reverse-Trendelenburg position on mean systemic filling pressure, venous return, and microcirculation during esophagectomy. J Thorac Dis. 2018;10(6):3399-08. DOI: 10.21037/jtd.2018.05.169. PMID: 30069335; PMCID: PMC6051808. DOI: https://doi.org/10.21037/jtd.2018.05.169
de Freitas Junior S, Bustorff-Silva JM, Ramos CD, Brunetto SQ, da Costa APM, Antunes AG, Biavatti BBV, Franchi Junior GC, Moreira MM, Felix PCG, Miranda ML. Scintigraphic Evaluation of the Impact of Pneumoperitoneum on Renal Blood Flow: A Rabbit Model. J Laparoendosc Adv Surg Tech A. 2019; 29(10):1271-75. DOI: 10.1089/lap.2019.0194. Epub. 2019 Sep. 4. PMID: 31483185. DOI: https://doi.org/10.1089/lap.2019.0194
Liu Y, Cao W, Liu Y, Wang Y, Lang R, Yue Y, Wu AS. Changes in duration of action of rocuronium following decrease in hepatic blood flow during pneumoperitoneum for laparoscopic gynaecological surgery. BMC Anesthesiol. 2017; 17(1):45. DOI: 10.1186/s12871-017-0335-1. PMID: 28320323; PMCID: PMC5359965. DOI: https://doi.org/10.1186/s12871-017-0335-1
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