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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

a. Sensitivity analysis. b. Funnel plot analysis to detect publication bias for ALT results on postoperative day 3; each point represents a separate study for the indicated association. c, Funnel plot analysis to detect publication bias for AST results on postoperative day 3; each point represents a separate study for the indicated association.
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pone-0104067-g003: a. Sensitivity analysis. b. Funnel plot analysis to detect publication bias for ALT results on postoperative day 3; each point represents a separate study for the indicated association. c, Funnel plot analysis to detect publication bias for AST results on postoperative day 3; each point represents a separate study for the indicated association.

Mentions: In the analyses above, there was a high degree of heterogeneity across trials. Publication bias was not evident in the results of postoperative day 1 (P = 0.30) or day 7 (P = 0.36), but it was observed in the results of postoperative day 3 (P = 0.02, Fig. 3B).


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)

a. Sensitivity analysis. b. Funnel plot analysis to detect publication bias for ALT results on postoperative day 3; each point represents a separate study for the indicated association. c, Funnel plot analysis to detect publication bias for AST results on postoperative day 3; each point represents a separate study for the indicated association.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0104067-g003: a. Sensitivity analysis. b. Funnel plot analysis to detect publication bias for ALT results on postoperative day 3; each point represents a separate study for the indicated association. c, Funnel plot analysis to detect publication bias for AST results on postoperative day 3; each point represents a separate study for the indicated association.
Mentions: In the analyses above, there was a high degree of heterogeneity across trials. Publication bias was not evident in the results of postoperative day 1 (P = 0.30) or day 7 (P = 0.36), but it was observed in the results of postoperative day 3 (P = 0.02, Fig. 3B).

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