TITLE

Abdominal wall-lifting versus CO2 pneumoperitoneum in laparoscopy: a review and meta-analysis

AUTHOR(S)
Hao Ren; Yao Tong; Xi-Bing Ding; Xin Wang; Shu-Qing Jin; Xiao-Yin Niu; Xiang Zhao; Quan Li
PUB. DATE
July 2014
SOURCE
International Journal of Clinical & Experimental Medicine;2014, Vol. 7 Issue 6, p1558
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The aim of this study is to compare the operative parameters and outcomes of conventional CO2-pneumoperitoneum (PP) versus gasless abdominal wall-lifting (AWL) for laparoscopic surgery. The literature databases of PubMed, Google Scholar and Cochrane Library were searched for randomized controlled trials (RCTs) that had compared the CO2-PP approach with that of gasless AWL for laparoscopic surgery and which had been published between 1995 and 2012. Data for the operative parameters (i.e. surgery duration, intraoperative heart rate (HR), perioperative complications, and postoperative duration of hospital stay and time to activity) and outcomes (postoperative shoulder pain, nausea/vomiting (PONV), partial pressure of CO2 in the blood (PaCO2), blood pH, and serum levels of the inflammatory cytokine interleukin (IL)-6) were extracted from the identified RCTs. RevMan software, version 5.2, was used for data synthesis and statistical analysis. Nineteen RCTs were selected for the meta-analysis, involving a total of 791 patients who had undergone laparoscopic operations with CO2-PP (n = 399) or gasless AWL (n = 392). Sub-group analysis indicated that the patients who underwent gasless AWL had significantly shorter postoperative time to activity (weighted mean difference (WMD) = -0.23 d, 95% confidence interval (CI): -0.37 to -0.09; P = 0.001), lower incidence of PONV (odds ratio (OR) = 0.24, 95% CI: 0.10 to 0.57; P = 0.001) and lower postoperative PaCO2 level (WMD = -3.09 mmHg, 95% CI: -4.66 to -1.53; P = 0.0001), compared to the patients who underwent CO2-PP. However, the CO2-PP method was associated with a significantly shorter surgery duration than the gasless AWL method (WMD = 8.61, 95% CI: 3.19 to 14.03; P = 0.002). There were no significant advantages detected for either approach with respect to the intraoperative HR, the perioperative complication rate, or the postoperative parameters of duration of hospital stay, shoulder pain, blood pH, or serum IL-6 level. We concluded form present study that the gasless AWL method has the features of shorter time, lower postoperative PaCO2, and lower PONV incidence while the CO2-PP method for laparoscopy requires shorter surgical time.
ACCESSION #
97121006

 

Related Articles

  • Endoscopic versus open component separation: systematic review and meta-analysis. Switzer, Noah; Dykstra, Mark; Gill, Richdeep; Lim, Stephanie; Lester, Erica; Gara, Christopher; Shi, Xinzhe; Birch, Daniel; Karmali, Shahzeer // Surgical Endoscopy;Apr2015, Vol. 29 Issue 4, p787 

    Background: The component separation technique (CST) was developed to improve the integrity of abdominal wall reconstruction for large, complex hernias. Open CST necessitates large subcutaneous skin flaps and, therefore, is associated with significant ischemic wound complications. The minimally...

  • Neuroimmune mechanisms in postoperative ileus. Boeckxstaens, E.; de Jonge, W. J. // Gut;Sep2009, Vol. 58 Issue 9, p1300 

    Postoperative ileus (POI) is a common clinical condition arising after almost every abdominal surgical procedure, leading to increased patient morbidity and prolonged hospitalisation. Recent advances in insight into the underlying pathophysiology have identified intestinal inflammation triggered...

  • Implementing an Enhanced Recovery Program After Pancreaticoduodenectomy in Elderly Patients: Is It Feasible? Coolsen, Mariëlle; Bakens, Maikel; Dam, Ronald; Olde Damink, Steven; Dejong, Cornelis // World Journal of Surgery;Jan2015, Vol. 39 Issue 1, p251 

    Background: An enhanced recovery after surgery (ERAS) program aims to reduce the stress response to surgery and thereby accelerate recovery. It is unclear whether these programs can be safely implemented for elderly patients, especially in highly complex surgery such as pancreaticoduodenectomy...

  • Comparison of a standard CO2 pressure pneumoperitoneum insufflator versus AirSealTM: study protocol of a randomized controlled trial. Luketina, Ruzica Rosalia; Michael, Michael; Köhler, Gernot; Koch, Oliver Owen; Strasser, Klaus; Egger, Margot; Emmanuel, Klaus // Trials;2014, Vol. 15 Issue 1, p1 

    Background AirSealâ„¢ is a novel class of valve-free insufflation system that enables a stable pneumoperitoneum with continuous smoke evacuation and carbon dioxide (CO2) recirculation during laparoscopic surgery. Comparison data to standard CO2 pressure pneumoperitoneum insufflators is...

  • omentopexy.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p1627 

    A definition of the term "omentopexy" which refers to the fixation of the omentum to the abdominal wall or adjacent organ is presented.

  • Complex Abdominal Wall Defects and Enterocutaneous Fistulae in the Era of Biological Mesh: Did We Make any Real Progress? Latifi, Rifat; Leppäniemi, Ari // World Journal of Surgery;Mar2012, Vol. 36 Issue 3, p495 

    An introduction is presented in which the editor discusses various reports within the issue on topics including complexities in surgery of abdominal wall defects, elective surgery and damage control surgery.

  • Commentary on Abdominoplasty. Yoho, Robert A. // International Journal of Cosmetic Surgery & Aesthetic Dermatolog;Mar2002, Vol. 4 Issue 1, p61 

    Comments on abdominoplasty as a faulty surgery. Basic premise of abdominal wall tightening; Abilities of dermatologists to perform abdominoplasty; Drawbacks of abdominoplasty.

  • Intraoperative vesical pressure measurements as a guide in the closure of abdominal wall defects. Rizzo, Anthony; Davis, Patricia C. // American Surgeon;Mar1996, Vol. 62 Issue 3, p192 

    Compares outcomes with and without vesical pressure measurements in abdominal wall defect (AWD) closure. Decreased urinary output in gastroschisis patients on the second postoperative day; Ventilator support; Total parenteral nutrition (TPN) days; Oral feeding data.

  • Experience with three prosthetic materials in temporary abdominal wall closure. Nagy, Kimberly K.; Fildes, John J. // American Surgeon;May1996, Vol. 62 Issue 5, p331 

    Presents a retrospective chart review of three prosthetic materials used for abdominal wall closures over a four-year period in the United States. Types of commonly used protheses; Types of complications.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics