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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Surgery
Volume 12 - 2024 | doi: 10.3389/fped.2024.1380985

Application of different CO2 pneumoperitoneum pressure in laparoscopic pyeloplasty for infants with ureteropelvic junction obstruction

Provisionally accepted
Yan Peng Yan Peng Min Zhu Min Zhu Chunmei Chen Chunmei Chen *
  • Nanjing Children's Hospital, Nanjing, Liaoning Province, China

The final, formatted version of the article will be published soon.

    Background: Laparoscopic pyeloplasty is a minimally invasive approach for the therapy of infant ureteropelvic junction obstruction (UPJO), reliant on CO2 pneumoperitoneum insufflation. While the impact of CO2 insufflation on adult and older pediatric populations has been studied, its effects on infants remain less explored.Methods: This prospective randomized controlled trial included infants with UPJO undergoing laparoscopic pyeloplasty. Patients were allocated to low pneumoperitoneum pressure (LPP, 5 mmHg) or high pneumoperitoneum pressure (HPP, 8 mmHg) groups. Surgical parameters, postoperative complications, acid-base balance, stress markers, inflammatory cytokines, and oxidative stress markers were evaluated and compared.Results: A total of 116 infants were analyzed. Preoperative characteristics were comparable between LPP and HPP groups. No significant differences in blood loss, operation time, or hospitalization time were observed. Postoperative complications were similar between groups. Acid-base balance analysis revealed a decrease in pH after pneumoperitoneum in both groups, with greater reductions in actual base excess and standard base excess in the HPP group. Stress markers, cytokines, and oxidative stress markers increased postoperatively in both groups, with higher levels in the HPP group.HPP leads to more pronounced physiological responses, including acidbase alterations, stress reactions, and inflammatory cytokine elevations.

    Keywords: Ureteropelvic junction obstruction, Laparoscopic pyeloplasty, CO2, pneumoperitoneum insufflation, cytokine

    Received: 05 Feb 2024; Accepted: 11 Sep 2024.

    Copyright: © 2024 Peng, Zhu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Chunmei Chen, Nanjing Children's Hospital, Nanjing, Liaoning Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.