LAPAROSCOPIC NEPHRECTOMY IN PIGS WITH IMP AIRED PULMONARY-FUNCTION

Hemodynamic changes caused by a pneumoperitoneum have been studied in healthy animals. In an experimental model in pigs with impaired pulmon ary function we wandted to examine the hemodynamic changes during lapa roscopic nephrectomy. 13 pigs were anesthetizid with azaperon/ketamine and ventilated with 67% nitrous oxide in oxygen. By i.v. injection of starch microsphers a capillary pulmonary embolism was induced. After embolisation 3 animals served as untreated controls (group 1), 5 anima ls underwent an open nephrectomy (group 2), and 5 underwent a laparosc opic nephrectomy (group 3). Group 3 developed a significant CO2 retent ion with a consecutive acidosis. There was a significant increase of c ardiac output volume from 3.6 1/min. (+/- 0.62) to 4.5 1/min. (+/- 0.4 7) in Group 3, whereas group 2 showed a significant decrease from 3.6 1 /min. (+/- 0.41) to 2.1 1/min. (+/- 1.2). The laparoscopic approach was in our model associated with a significant increase of cardiac out put, whereas open surgery was combined with a significant decrease.