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首页> 外文期刊>Surgical Endoscopy >Randomized controlled trial comparing three methods of liver retraction in laparoscopic Roux-en-Y gastric bypass
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Randomized controlled trial comparing three methods of liver retraction in laparoscopic Roux-en-Y gastric bypass

机译：随机对照试验比较腹腔镜Roux-en-Y胃旁路术中三种肝退缩方法

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Background: This study aimed to evaluate differences between three methods of liver retraction during laparoscopic Roux-en-Y Gastric bypass (LRYGB) and to compare novel liver retraction techniques with the traditional mechanical liver retractor in a randomized controlled trial. Methods: In this study, 60 obese patients (26 males and 34 females) who underwent LRYGB between January and July 2010 were randomized to one of three groups (20 in each): group 1 (Nathanson liver retractor), group 2 (liver suspension tape), and group 3 (V-shaped liver suspension technique [V-LIST]). Data regarding demographics (age, sex, body mass index); liver function test (LFT) just before surgery; postoperative results immediately, then 18 h, 1 week, and 1 month after surgery; operative data, and visual analog scale (VAS) for pain on postoperative days (PODs) 1 and 2 were calculated and analyzed. Results: The groups did not differ significantly in terms of preoperative LFT or operative data except that group 3 took significantly longer time for liver suspension than group 1 (p = 0.01) or group 2 (p = 0.03). The VAS score in group 2 was significantly lower on POD 1 than in group 1 (p = 0.04). Group 1 showed a significant rise in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) at 18 h compared with group 2 (p < 0.01 and p = 0.02, respectively) and group 3 (p < 0.01 and p = 0.01), at 1 week compared with group 2 (p = 0.04 and 0.04), and in AST levels alone during the immediate postoperative compared with group 3 (p = 0.04). Conclusion: The Nathanson liver retractor causes more liver dysfunction than V-LIST or the liver suspension technique and causes more postoperative pain than the liver suspension technique. Both V-LIST and liver suspension tape have a short learning curve and implications for single-port surgery.
机译：背景：本研究旨在评估腹腔镜Roux-en-Y胃旁路术（LRYGB）期间三种肝收缩方法之间的差异，并在一项随机对照试验中比较新型肝收缩技术与传统机械肝收缩器。方法：在本研究中，将60名在2010年1月至2010年7月间接受LRYGB治疗的肥胖患者（男26例，女34例）随机分为三组（每组20例）之一：第1组（Nathanson肝牵开器），第2组（肝悬吊）胶带）和第3组（V形肝悬液技术[V-LIST]）。有关人口统计数据（年龄，性别，体重指数）;手术前的肝功能检查（LFT）;手术后18小时，1周和1个月立即获得术后结果;计算并分析手术数据以及术后1天和2天的疼痛视觉模拟量表（VAS）。结果：各组在术前LFT或手术数据方面无显着差异，只是第3组的肝悬浮时间比第1组（p = 0.01）或第2组（p = 0.03）长得多。第2组的VAS评分在POD 1上显着低于第1组（p = 0.04）。与第2组（分别为p <0.01和p = 0.02）和第3组（p <0.01和p = 0.01）相比，第1组在18 h时天门冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）显着升高。与第2组相比分别为1周（p = 0.04和0.04），而在术后即刻与单独使用AST水平相比，与第3组相比（p = 0.04）。结论：Nathanson肝牵开器比V-LIST或肝悬挂技术引起的肝功能障碍更多，并且比肝悬挂技术引起的术后疼痛更大。 V-LIST和肝悬吊带都具有较短的学习曲线，对单端口手术具有重要意义。

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