Pretreatment with endothelium-derived nitric oxide synthesis modulators on gastrointestinal microcirculation during NOTES: an experimental study
| Autor: | Alberto Delitala, Antonio M. Lacy, Marina Vendrell, Salvadora Delgado, Cedric Adelsdorfer, A. Ibarzabal, Pilar Taura, Ramon Deulofeu, Borja de Lacy |
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| Rok vydání: | 2016 |
| Předmět: |
Natural Orifice Endoscopic Surgery
Pathology medicine.medical_specialty Endothelium Swine Renal cortex Urology 030204 cardiovascular system & hematology Nitric Oxide Nitric oxide Microcirculation Random Allocation 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Abdomen Renal medulla medicine Animals Cholecystectomy business.industry Insufflation Blood flow Acetylcysteine Hypertonic saline medicine.anatomical_structure chemistry Models Animal Preoperative Period Female 030211 gastroenterology & hepatology Surgery medicine.symptom business Vasoconstriction |
| Zdroj: | Surgical Endoscopy. 30:5232-5238 |
| ISSN: | 1432-2218 0930-2794 |
| Popis: | On-demand endoscopic insufflation during natural orifice transluminal endoscopic surgery (NOTES) adversely affects microcirculatory blood flow (MBF), even with low mean intra-abdominal pressure, suggesting that shear stress caused by time-varying flow fluctuations has a great impact on microcirculation. As shear stress is inversely related to vascular diameter, nitric oxide (NO) production acts as a brake to vasoconstriction. To assess whether pretreatment by NO synthesis modulators protects gastrointestinal MBF during transgastric peritoneoscopy. Fourteen pigs submitted to cholecystectomy by endoscope CO2 insufflation for 60 min were randomized into 2 groups: (1) 150 mg/kg of N-acetyl cysteine (NAC, n = 7) and (2) 4 ml/kg of hypertonic saline 7.5 % (HS, n = 7), and compared to a non-treated NOTES group (n = 7). Five animals made up a sham group. Colored microspheres were used to assess changes in MBF. The average level of intra-abdominal pressure was similar in all groups (9 mmHg). In NOTES group microcirculation decrease compared with baseline was greater in renal cortex, mesocolon, and mesentery (41, 42, 44 %, respectively, p |
| Databáze: | OpenAIRE |
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