Esra TEMİZER, Şemsi Mustafa AKSOY, Gökhan ERDEM
Journal of Comprehensive Surgery - 2026;4(2):30-35
Aims: Various surgical procedures are performed on patients in the prone position. Intra-abdominal pressure (IAP) refers to the pressure within the abdominal cavity between the internal organs and the abdominal wall. This study investigated the effect of the prone position-via increased IAP-on renal function. Methods: This prospective observational study included patients aged 18-75 years with an American Society of Anesthesiologists (ASA) classification of I-III. 38 patients undergoing spinal surgery in the prone position and 37 patients undergoing colorectal surgery in the supine position were evaluated. Demographic characteristics, IAP , perioperative renal parameters, intraoperative blood loss, and postoperative course were assessed. IAP was measured by intravesical pressure monitoring. Results: In patients undergoing lumbar surgery, IAP was significantly higher in the prone position (14 mmHg) compared with the supine position (11 mmHg; p<0.05). The incidence of class I intra-abdominal hypertension (IAH) was significantly higher in the prone position than in the supine position (p<0.001). A positive and significant correlation was found between body-mass index and IAP in both patients undergoing lumbar and colorectal surgery (p<0.001). Postoperative urea levels at 1, 24, and 48 hours were significantly higher in patients who underwent lumbar surgery (p<0.05). Among those undergoing colorectal surgery, patients with class I IAH had significantly higher intraoperative blood loss than those with normal IAP (p<0.05). Conclusion: To prevent renal complications during surgery, patient positioning and fluid management should be monitored carefully. In addition, it should be noted that increased IAP can lead to greater intraoperative blood loss.
