Value of diagnostic and therapeutic laparoscopy for patients with blunt abdominal trauma: A 10-year medical center experience
Journal
PLoS ONE
Journal Volume
13
Journal Issue
2
Pages
e0193379
Date Issued
2018
Author(s)
Abstract
Laparoscopy has been used for the diagnosis and treatment for hemodynamically stable patients with penetrating abdominal trauma. This study evaluated whether diagnostic and therapeutic laparoscopy can be used as effectively in select patients with blunt abdominal trauma. All hemodynamically stable patients undergoing operations for blunt abdominal trauma over a 10-year period (2006–2015) at a tertiary medical center were included. Patients undergoing laparotomy were categorized as group A. Patients who underwent laparoscopy were categorized as group B. The clinical outcomes of the 2 groups were compared. There were 139 patients in group A and 126 patients in group B. Group A patients were more severely injured (mean injury severity score of 23.3 vs. 18.9, P < .001) and had a higher frequency of traumatic brain injuries (25.2% vs. 14.3%, P = .039). The sensitivity and specificity of diagnostic laparoscopy for patients in group B was 99.1% and 100.0%, respectively. No non-therapeutic laparotomies were performed in group B, and the success rate of therapeutic laparoscopy was 92.0% (103/112) for patients with significant intra-abdominal injuries. Patients in the 2 groups had similar perioperative and postoperative outcomes in terms of operation times, blood loss, blood transfusion requirements, mortality, and complications (all, P > .05). Laparoscopy is a feasible and safe tool for the diagnosis and treatment of hemodynamically stable patients with blunt abdominal trauma who require surgery. ? 2018 Lin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
SDGs
Other Subjects
abdominal abscess; abdominal blunt trauma; abdominal wall hernia; adult; Article; artificial embolization; bladder surgery; blood transfusion; cholecystectomy; colon injury; colon resection; controlled study; diagnostic value; diaphragm injury; distal pancreatectomy; female; fluid resuscitation; hernioplasty; human; hypotension; injury scale; injury severity; intestine anastomosis; intestine injury; intestine resection; laparoscopy; laparotomy; liver injury; liver resection; major clinical study; male; mortality; nephrectomy; operation duration; operative blood loss; pancreas injury; perioperative period; postoperative ileus; postoperative period; rectum injury; reoperation; retrospective study; sensitivity and specificity; spleen injury; splenectomy; stomach surgery; surgical infection; traumatic brain injury; treatment outcome; abdominal injury; blunt trauma; laparoscopy; middle aged; procedures; tertiary care center; young adult; Abdominal Injuries; Adult; Female; Humans; Injury Severity Score; Laparoscopy; Male; Middle Aged; Operative Time; Retrospective Studies; Sensitivity and Specificity; Tertiary Care Centers; Wounds, Nonpenetrating; Young Adult
Type
journal article