Differential advantage of liver retraction methods in laparoscopic fundoplication for neurologically impaired patients: a comparison of three kinds of procedures
Aim of the study Liver retraction during laparoscopic fundoplication is important for obtaining an optimal space. Several methods have been developed, but the risks and benefits are unclear. We compared three different approaches and evaluated their safety and utility. Methods Forty-three neurologic...
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| Veröffentlicht in: | Pediatric surgery international 2020-05, Vol.36 (5), p.591-596 |
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| creator | Harumatsu, Toshio Nagai, Taichiro Yano, Keisuke Onishi, Shun Yamada, Koji Yamada, Waka Matsukubo, Makoto Muto, Mitsuru Kaji, Tatsuru Ieiri, Satoshi |
| description | Aim of the study
Liver retraction during laparoscopic fundoplication is important for obtaining an optimal space. Several methods have been developed, but the risks and benefits are unclear. We compared three different approaches and evaluated their safety and utility.
Methods
Forty-three neurologically impaired patients who underwent laparoscopic fundoplication between 2005 and 2018 were classified into three groups: A, snake retractor method,
n
= 18; B, crural suture method,
n
= 13; C, needle grasper method,
n
= 12. Patients’ characteristics and outcomes were reviewed.
Main results
The liver retraction time was significantly shorter in group C than in A or B (
p
|
| doi_str_mv | 10.1007/s00383-020-04646-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2381625277</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2391146142</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-89d5c899c5bc8b9e2b5fddbf5da37a9498a42b7c80c2e07cf548a835fad778f43</originalsourceid><addsrcrecordid>eNp9kc9uFiEUxYmxsV-rL-DCkLhxM5Z_M4A7U62aNOlG1xMGLl-pDIww06SP45sW-1VNXLgiXH7nnBsOQi8peUsJkWeVEK54RxjpiBjE0KknaEcFl51WlD9FO0Kl7gjv1TE6qfWGEKL4oJ-hY86oVgMjO_TzQ_AeCqQ1mIiNuzVpNXvA2eMYbqHgAmsxdg054RnW6-wqDglHs5iSq81LsNhvyeUlBmseMJ8LTrCVHPO-zWK8w2FeTCjg8NKQllXfYYNtbtMSapO0tPW6AODvIbWAdl1KtuC2AvU5OvImVnjxeJ6ibxcfv55_7i6vPn05f3_ZWSHo2intequ0tv1k1aSBTb13bvK9M1waLbQygk3SKmIZEGl9L5RRvPfGSam84KfozcG3Rf_YoK7jHKqFGE2CvNWRcUUH1jMpG_r6H_QmbyW17RqlKRUDFaxR7EDZ9lO1gB-XEmZT7kZKxl8FjocCx1bg-FDgqJro1aP1Ns3g_kh-N9YAfgBqe0p7KH-z_2N7D871qug</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2391146142</pqid></control><display><type>article</type><title>Differential advantage of liver retraction methods in laparoscopic fundoplication for neurologically impaired patients: a comparison of three kinds of procedures</title><source>MEDLINE</source><source>SpringerLink (Online service)</source><creator>Harumatsu, Toshio ; Nagai, Taichiro ; Yano, Keisuke ; Onishi, Shun ; Yamada, Koji ; Yamada, Waka ; Matsukubo, Makoto ; Muto, Mitsuru ; Kaji, Tatsuru ; Ieiri, Satoshi</creator><creatorcontrib>Harumatsu, Toshio ; Nagai, Taichiro ; Yano, Keisuke ; Onishi, Shun ; Yamada, Koji ; Yamada, Waka ; Matsukubo, Makoto ; Muto, Mitsuru ; Kaji, Tatsuru ; Ieiri, Satoshi</creatorcontrib><description>Aim of the study
Liver retraction during laparoscopic fundoplication is important for obtaining an optimal space. Several methods have been developed, but the risks and benefits are unclear. We compared three different approaches and evaluated their safety and utility.
Methods
Forty-three neurologically impaired patients who underwent laparoscopic fundoplication between 2005 and 2018 were classified into three groups: A, snake retractor method,
n
= 18; B, crural suture method,
n
= 13; C, needle grasper method,
n
= 12. Patients’ characteristics and outcomes were reviewed.
Main results
The liver retraction time was significantly shorter in group C than in A or B (
p
< 0.05). The operative times were shorter in groups B and C than in A. There were no significant differences in the liver enzyme levels. The liver enzyme levels increased temporarily but improved within a week. The C-reactive protein levels were significantly lower in group B than in A or C (
p
< 0.05).
Conclusions
The most convenient method was the needle grasper method, as the other two approaches create conflict with the operator’s forceps. The crural suture method damages the liver less, but requires higher surgical skill levels. It is important to select the appropriate method according to the operator’s skill and the patient’s size and deformity.</description><identifier>ISSN: 0179-0358</identifier><identifier>EISSN: 1437-9813</identifier><identifier>DOI: 10.1007/s00383-020-04646-8</identifier><identifier>PMID: 32198620</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Child ; Enzymes ; Female ; Fundoplication - methods ; Gastroesophageal Reflux - complications ; Gastroesophageal Reflux - surgery ; Humans ; Laparoscopy ; Laparoscopy - methods ; Liver ; Liver - surgery ; Male ; Medicine ; Medicine & Public Health ; Methods ; Neurodevelopmental Disorders - complications ; Operative Time ; Original Article ; Pediatric Surgery ; Pediatrics ; Retrospective Studies ; Surgery ; Suture Techniques ; Young Adult</subject><ispartof>Pediatric surgery international, 2020-05, Vol.36 (5), p.591-596</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-89d5c899c5bc8b9e2b5fddbf5da37a9498a42b7c80c2e07cf548a835fad778f43</citedby><cites>FETCH-LOGICAL-c441t-89d5c899c5bc8b9e2b5fddbf5da37a9498a42b7c80c2e07cf548a835fad778f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00383-020-04646-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00383-020-04646-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32198620$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harumatsu, Toshio</creatorcontrib><creatorcontrib>Nagai, Taichiro</creatorcontrib><creatorcontrib>Yano, Keisuke</creatorcontrib><creatorcontrib>Onishi, Shun</creatorcontrib><creatorcontrib>Yamada, Koji</creatorcontrib><creatorcontrib>Yamada, Waka</creatorcontrib><creatorcontrib>Matsukubo, Makoto</creatorcontrib><creatorcontrib>Muto, Mitsuru</creatorcontrib><creatorcontrib>Kaji, Tatsuru</creatorcontrib><creatorcontrib>Ieiri, Satoshi</creatorcontrib><title>Differential advantage of liver retraction methods in laparoscopic fundoplication for neurologically impaired patients: a comparison of three kinds of procedures</title><title>Pediatric surgery international</title><addtitle>Pediatr Surg Int</addtitle><addtitle>Pediatr Surg Int</addtitle><description>Aim of the study
Liver retraction during laparoscopic fundoplication is important for obtaining an optimal space. Several methods have been developed, but the risks and benefits are unclear. We compared three different approaches and evaluated their safety and utility.
Methods
Forty-three neurologically impaired patients who underwent laparoscopic fundoplication between 2005 and 2018 were classified into three groups: A, snake retractor method,
n
= 18; B, crural suture method,
n
= 13; C, needle grasper method,
n
= 12. Patients’ characteristics and outcomes were reviewed.
Main results
The liver retraction time was significantly shorter in group C than in A or B (
p
< 0.05). The operative times were shorter in groups B and C than in A. There were no significant differences in the liver enzyme levels. The liver enzyme levels increased temporarily but improved within a week. The C-reactive protein levels were significantly lower in group B than in A or C (
p
< 0.05).
Conclusions
The most convenient method was the needle grasper method, as the other two approaches create conflict with the operator’s forceps. The crural suture method damages the liver less, but requires higher surgical skill levels. It is important to select the appropriate method according to the operator’s skill and the patient’s size and deformity.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>Enzymes</subject><subject>Female</subject><subject>Fundoplication - methods</subject><subject>Gastroesophageal Reflux - complications</subject><subject>Gastroesophageal Reflux - surgery</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Liver</subject><subject>Liver - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methods</subject><subject>Neurodevelopmental Disorders - complications</subject><subject>Operative Time</subject><subject>Original Article</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Suture Techniques</subject><subject>Young Adult</subject><issn>0179-0358</issn><issn>1437-9813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc9uFiEUxYmxsV-rL-DCkLhxM5Z_M4A7U62aNOlG1xMGLl-pDIww06SP45sW-1VNXLgiXH7nnBsOQi8peUsJkWeVEK54RxjpiBjE0KknaEcFl51WlD9FO0Kl7gjv1TE6qfWGEKL4oJ-hY86oVgMjO_TzQ_AeCqQ1mIiNuzVpNXvA2eMYbqHgAmsxdg054RnW6-wqDglHs5iSq81LsNhvyeUlBmseMJ8LTrCVHPO-zWK8w2FeTCjg8NKQllXfYYNtbtMSapO0tPW6AODvIbWAdl1KtuC2AvU5OvImVnjxeJ6ibxcfv55_7i6vPn05f3_ZWSHo2intequ0tv1k1aSBTb13bvK9M1waLbQygk3SKmIZEGl9L5RRvPfGSam84KfozcG3Rf_YoK7jHKqFGE2CvNWRcUUH1jMpG_r6H_QmbyW17RqlKRUDFaxR7EDZ9lO1gB-XEmZT7kZKxl8FjocCx1bg-FDgqJro1aP1Ns3g_kh-N9YAfgBqe0p7KH-z_2N7D871qug</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Harumatsu, Toshio</creator><creator>Nagai, Taichiro</creator><creator>Yano, Keisuke</creator><creator>Onishi, Shun</creator><creator>Yamada, Koji</creator><creator>Yamada, Waka</creator><creator>Matsukubo, Makoto</creator><creator>Muto, Mitsuru</creator><creator>Kaji, Tatsuru</creator><creator>Ieiri, Satoshi</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20200501</creationdate><title>Differential advantage of liver retraction methods in laparoscopic fundoplication for neurologically impaired patients: a comparison of three kinds of procedures</title><author>Harumatsu, Toshio ; Nagai, Taichiro ; Yano, Keisuke ; Onishi, Shun ; Yamada, Koji ; Yamada, Waka ; Matsukubo, Makoto ; Muto, Mitsuru ; Kaji, Tatsuru ; Ieiri, Satoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-89d5c899c5bc8b9e2b5fddbf5da37a9498a42b7c80c2e07cf548a835fad778f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>Enzymes</topic><topic>Female</topic><topic>Fundoplication - methods</topic><topic>Gastroesophageal Reflux - complications</topic><topic>Gastroesophageal Reflux - surgery</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Liver</topic><topic>Liver - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methods</topic><topic>Neurodevelopmental Disorders - complications</topic><topic>Operative Time</topic><topic>Original Article</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Suture Techniques</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harumatsu, Toshio</creatorcontrib><creatorcontrib>Nagai, Taichiro</creatorcontrib><creatorcontrib>Yano, Keisuke</creatorcontrib><creatorcontrib>Onishi, Shun</creatorcontrib><creatorcontrib>Yamada, Koji</creatorcontrib><creatorcontrib>Yamada, Waka</creatorcontrib><creatorcontrib>Matsukubo, Makoto</creatorcontrib><creatorcontrib>Muto, Mitsuru</creatorcontrib><creatorcontrib>Kaji, Tatsuru</creatorcontrib><creatorcontrib>Ieiri, Satoshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric surgery international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harumatsu, Toshio</au><au>Nagai, Taichiro</au><au>Yano, Keisuke</au><au>Onishi, Shun</au><au>Yamada, Koji</au><au>Yamada, Waka</au><au>Matsukubo, Makoto</au><au>Muto, Mitsuru</au><au>Kaji, Tatsuru</au><au>Ieiri, Satoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differential advantage of liver retraction methods in laparoscopic fundoplication for neurologically impaired patients: a comparison of three kinds of procedures</atitle><jtitle>Pediatric surgery international</jtitle><stitle>Pediatr Surg Int</stitle><addtitle>Pediatr Surg Int</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>36</volume><issue>5</issue><spage>591</spage><epage>596</epage><pages>591-596</pages><issn>0179-0358</issn><eissn>1437-9813</eissn><abstract>Aim of the study
Liver retraction during laparoscopic fundoplication is important for obtaining an optimal space. Several methods have been developed, but the risks and benefits are unclear. We compared three different approaches and evaluated their safety and utility.
Methods
Forty-three neurologically impaired patients who underwent laparoscopic fundoplication between 2005 and 2018 were classified into three groups: A, snake retractor method,
n
= 18; B, crural suture method,
n
= 13; C, needle grasper method,
n
= 12. Patients’ characteristics and outcomes were reviewed.
Main results
The liver retraction time was significantly shorter in group C than in A or B (
p
< 0.05). The operative times were shorter in groups B and C than in A. There were no significant differences in the liver enzyme levels. The liver enzyme levels increased temporarily but improved within a week. The C-reactive protein levels were significantly lower in group B than in A or C (
p
< 0.05).
Conclusions
The most convenient method was the needle grasper method, as the other two approaches create conflict with the operator’s forceps. The crural suture method damages the liver less, but requires higher surgical skill levels. It is important to select the appropriate method according to the operator’s skill and the patient’s size and deformity.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32198620</pmid><doi>10.1007/s00383-020-04646-8</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-0358 |
| ispartof | Pediatric surgery international, 2020-05, Vol.36 (5), p.591-596 |
| issn | 0179-0358 1437-9813 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2381625277 |
| source | MEDLINE; SpringerLink (Online service) |
| subjects | Adolescent Adult Child Enzymes Female Fundoplication - methods Gastroesophageal Reflux - complications Gastroesophageal Reflux - surgery Humans Laparoscopy Laparoscopy - methods Liver Liver - surgery Male Medicine Medicine & Public Health Methods Neurodevelopmental Disorders - complications Operative Time Original Article Pediatric Surgery Pediatrics Retrospective Studies Surgery Suture Techniques Young Adult |
| title | Differential advantage of liver retraction methods in laparoscopic fundoplication for neurologically impaired patients: a comparison of three kinds of procedures |
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