Document Detail

Effect of laparoscopy and laparotomy on energy and protein metabolism in children: a randomized controlled trial.
MedLine Citation:
PMID:  20400097     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare the effects of surgery on energy and protein metabolism in children randomized to undergo laparoscopic and open surgery. STUDY DESIGN: We randomized 41 patients to open or laparoscopic Nissen fundoplication. Anesthesia and postoperative management were standardized. We recorded core temperature, respiratory gas exchange preoperatively, intraoperatively, and 4 and 24 hours postoperatively and calculated resting energy expenditure (REE). Protein breakdown was measured by using stable isotopic leucine infusion preoperatively and 4 hours postoperatively. RESULTS: Intraoperative core temperature and oxygen consumption increased in the laparoscopic group compared with the open group. REE decreased in the early postoperative period in the open group, but did not decrease after laparoscopy. REE at 4 hours was higher after laparoscopy. Protein breakdown also decreased in the early postoperative period; the pattern of change between open and laparoscopic groups was of borderline significance. CONCLUSIONS: Laparoscopy in children may alter the changes in energy metabolism observed after open surgery. These differences may be partially caused by alterations in intraoperative thermoregulation and protein breakdown during laparoscopy in children.
Merrill McHoney; Simon Eaton; Angie Wade; Virgilio Carnielli; Ed Kiely; David Drake; Joe Curry; Agostino Pierro
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-04-18
Journal Detail:
Title:  The Journal of pediatrics     Volume:  157     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  439-44, 444.e2     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 Mosby, Inc. All rights reserved.
Department of Pediatric Surgery, Institute of Child Health and Great Ormond Street Hospital for Children, London, United Kingdom.
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MeSH Terms
Child, Preschool
Double-Blind Method
Energy Metabolism*
Fundoplication / methods
Proteins / metabolism*
Reg. No./Substance:

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