The degree of retroperitoneal compression and the state of the endothelium during retroperitoneal operations

Lobanov Yuri Sergeevich, Lobanov Sergey Leonidovich, Vasiltsova Natalia Alexandrovna, Lobanov Leonid Sergeevich

To perform endosurgical operations in the retroperitoneal space, it is necessary to create and maintain a retropneumoperitoneum. In this case, there is pressure on the surrounding tissues and vessels, especially venous pressure. In this case, there is a slowdown in blood flow and an increased risk of thromboembolic complications. The level of safety of retroperitoneal compression is not well understood. The purpose of the work: to study the function of the endothelium and platelet aggregation, at various degrees of carbon dioxide pressure in maintaining retropneumoperitoneum during retroperitoneal endosurgical operations. Studies were carried out in 46 patients. The first group included 22 patients operated on at a pressure regimen of less than 12 mm Hg. The second group included 24 patients with a regimen of -12-16 mm Hg. Results and discussion. No significant changes in the studied parameters were found in the 1st group of patients. In the second group, an increase in the level and speed of induced aggregation by 11% and 14% was found, as well as a significant increase in the level of endothelin-1 and circulating endothelial cells, in the third, the most pronounced changes in these indicators were found. Conclusion. At higher compression (over 12 mmHg), induced platelet aggregation increases and signs of endothelial dysfunction appear, which may indicate a microcirculation disorder and an increased risk of thrombotic complications.

Keywords: retroperitoneal space, platelet aggregation, endothelial dysfunction.