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Association between duration of carbon dioxide pneumoperitoneum during laparoscopic abdominal surgery and hepatic injury: a meta-analysis.

Lai H, Mo X, Yang Y, Xiao J, He K, Chen J, Lin Y - PLoS ONE (2014)

Bottom Line: The outcome of interest was postoperative liver function (ALT, AST, TB).Eleven comparative studies involving 2,235 participants were included.Overall, levels of ALT, AST, and TB (on postoperative days 1, 3, and 7) were significantly elevated in the study groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, China.

ABSTRACT

Background: The aim of this study is to accurately assess whether the duration of intraoperative carbon dioxide pneumoperitoneum (CDP) is associated with the induction of hepatic injury.

Methods: We conducted a systematic review of PubMed, Embase, and Cochrane Library databases (through February 2014) to identify case-match studies that compared high-pressure CDP with low-pressure CDP or varied the duration of CDP in patients who underwent abdominal surgery. The outcome of interest was postoperative liver function (ALT, AST, TB).

Results: Eleven comparative studies involving 2,235 participants were included. Overall, levels of ALT, AST, and TB (on postoperative days 1, 3, and 7) were significantly elevated in the study groups. However, the results of the subanalyses of those who underwent laparoscopic colorectal cancer resection (LCR) versus open colorectal cancer resection (OCR) and those who underwent laparoscopic gastric bypass (LGBP) versus open gastric bypass (OGBP) were inconsistent.

Conclusions: The current evidence suggests that the duration of CDP during laparoscopic abdominal surgery may be associated with hepatic injury. Additional large-scale, randomized, controlled trials are urgently needed to further confirm this.

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Related in: MedlinePlus

Flow chart for the systematic search and study selection strategy.
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pone-0104067-g001: Flow chart for the systematic search and study selection strategy.

Mentions: Figure 1 depicts a PRISMA flow chart for study inclusion and exclusion. A total of 1,132 records were retrieved from the database search and 13 were identified through manual searches of the reference lists of relevant articles. After omitting duplicate results, 1,030 records remained. Of these, 19 were selected for full-text examination. Eight of these were then excluded for the following reasons: raw data could not be extracted in an appropriate format (n = 5) [20], [21], [22], [23], [24], the comparator was not of interest (n = 1) [12], or no full text was available (n = 2) [25], [26]. Eleven studies fulfilled the inclusion criteria and were included in the meta-analysis [6], [7], [8], [9], [10], [11], [13], [14], [15], [16], [27].


Association between duration of carbon dioxide pneumoperitoneum during laparoscopic abdominal surgery and hepatic injury: a meta-analysis.

Lai H, Mo X, Yang Y, Xiao J, He K, Chen J, Lin Y - PLoS ONE (2014)

Flow chart for the systematic search and study selection strategy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4128655&req=5

pone-0104067-g001: Flow chart for the systematic search and study selection strategy.
Mentions: Figure 1 depicts a PRISMA flow chart for study inclusion and exclusion. A total of 1,132 records were retrieved from the database search and 13 were identified through manual searches of the reference lists of relevant articles. After omitting duplicate results, 1,030 records remained. Of these, 19 were selected for full-text examination. Eight of these were then excluded for the following reasons: raw data could not be extracted in an appropriate format (n = 5) [20], [21], [22], [23], [24], the comparator was not of interest (n = 1) [12], or no full text was available (n = 2) [25], [26]. Eleven studies fulfilled the inclusion criteria and were included in the meta-analysis [6], [7], [8], [9], [10], [11], [13], [14], [15], [16], [27].

Bottom Line: The outcome of interest was postoperative liver function (ALT, AST, TB).Eleven comparative studies involving 2,235 participants were included.Overall, levels of ALT, AST, and TB (on postoperative days 1, 3, and 7) were significantly elevated in the study groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, China.

ABSTRACT

Background: The aim of this study is to accurately assess whether the duration of intraoperative carbon dioxide pneumoperitoneum (CDP) is associated with the induction of hepatic injury.

Methods: We conducted a systematic review of PubMed, Embase, and Cochrane Library databases (through February 2014) to identify case-match studies that compared high-pressure CDP with low-pressure CDP or varied the duration of CDP in patients who underwent abdominal surgery. The outcome of interest was postoperative liver function (ALT, AST, TB).

Results: Eleven comparative studies involving 2,235 participants were included. Overall, levels of ALT, AST, and TB (on postoperative days 1, 3, and 7) were significantly elevated in the study groups. However, the results of the subanalyses of those who underwent laparoscopic colorectal cancer resection (LCR) versus open colorectal cancer resection (OCR) and those who underwent laparoscopic gastric bypass (LGBP) versus open gastric bypass (OGBP) were inconsistent.

Conclusions: The current evidence suggests that the duration of CDP during laparoscopic abdominal surgery may be associated with hepatic injury. Additional large-scale, randomized, controlled trials are urgently needed to further confirm this.

Show MeSH
Related in: MedlinePlus