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首页> 外文期刊>Surgical Endoscopy >Effects of pneumoperitoneum and body position on the morphology of the caudal cava vein analyzed by MRI and plastinated sections.
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Effects of pneumoperitoneum and body position on the morphology of the caudal cava vein analyzed by MRI and plastinated sections.

机译：气腹和体位对MRI和塑化切片分析的尾腔静脉形态的影响。

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摘要

Pneumoperitoneum and patient positioning are essential factors during laparoscopic surgical procedures. They cause hemodynamic and anatomical changes in several abdominal organs among which the caudal cava vein (CCV) is involved. Hemodynamic changes in this vein (decreased venous return) have been described in the porcine model, but how the vein morphology and size is affected at different abdominal levels is unknown. We sought to assess the morphological and morphometrical changes in the CCV of the pig caused by pneumoperitoneum and the reverse Trendelenburg position by in vivo magnetic resonance imaging (MRI).Six pigs were scanned via MRI under four situations: S1, control (no pneumoperitoneum); S2, control in the reverse Trendelenburg position; S3, pneumoperitoneum (14 mmHg); and S4, pneumoperitoneum in the reverse Trendelenburg position. MRI and plastinated body sections were used to evaluate the topography, morphology and cross-sectional area of the CCV.Two portions of the CCV were differentiated: a prehepatic portion (located between the vertebral levels L1-T15) with flat and irregular morphology, and a hepatic portion (between T14-T11) that was almost rounded. The reverse Trendelenburg position caused an increase in the lumen affecting mainly the prehepatic portion, while pneumoperitoneum caused a decrease in the total vascular lumen, exerting a greater effect on the hepatic portion. The combination of both situations resulted in a further decrease in the vascular area and global morphological changes.The pneumoperitoneum and reverse Trendelenburg position caused morphological and morphometrical changes in the prehepatic and hepatic portions of the CCV, which should assist in gaining a better understanding of the hemodynamic changes described in the literature.
机译：气腹和患者定位是腹腔镜手术过程中的重要因素。它们在涉及尾腔静脉（CCV）的几个腹部器官中引起血液动力学和解剖学变化。猪模型中已经描述了该静脉的血液动力学变化（静脉回流减少），但是在不同的腹部水平如何影响静脉的形态和大小尚不清楚。我们试图通过体内磁共振成像（MRI）评估由猪气腹引起的CCV形态和形态学变化以及特伦德伦伯卧位的反向变化。通过MRI在六种情况下对六头猪进行了扫描：S1，对照（无气腹） ; S2，控制在特伦德伦伯卧位的反向位置; S3，气腹（14 mmHg）;和S4，气腹位于特伦德伦伯卧位的反向位置。使用MRI和塑化的身体切片来评估CCV的地形，形态和横截面积，区分出CCV的两个部分：肝前部分（位于椎骨水平L1-T15之间），具有平坦和不规则的形态，以及几乎是圆形的肝部分（在T14-T11之间）。特伦德伦伯卧位的反向位置导致主要影响肝前部分的内腔增加，而气腹引起总血管内腔的减少，对肝部分产生更大的影响。两种情况的结合导致了血管面积的进一步减少和整体形态学改变。气腹和特伦德伦伯卧位的逆转引起CCV肝前和肝部分的形态学和形态学变化，这应有助于更好地了解CCV。文献中描述了血液动力学变化。

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