Influence of Trendelenburg position and pneumoperitoneum treatment on gastroesophageal reflux in dogs.

Abstract

Gastroesophageal reflux is a latent factor that may cause esophagitis, esophageal stenosis, and aspiration pneumonia through the regurgitation of the gastric fluid contents. For laparoscopic surgery, posture-changing and pneumoperitoneum operations are conducted to develop the visual field. However, few studies have examined the influence of these operations on gastroesophageal reflux. In this experiment using 10 Beagles, 10 mL of contrast medium was administered into the stomach, and the dogs were placed in the Trendelenburg position with 10-degree tilting. Pneumoperitoneum treatment with carbon dioxide was performed, with an intraperitoneal pressure of 10 mmHg. The presence or absence of gastroesophageal reflux was evaluated using computed tomography (CT). In horizontal and Trendelenburg positions, there was no reflux of Contrast medium. However, reflux was observed in the Trendelenburg position under pneumoperitoneum (p<0.05). These results suggest that the risk of gastroesophageal reflux increases during laparoscopic surgery in the Trendelenburg position with 10-degree tilting under an intraperitoneal pressure of 10 mmHg.