INTRODUCTION: Laparoscopy is well-established in the elective setting, and is being more used in emergency surgeries. However, laparoscopic management of trauma patients is still limited for various reasons, including lack of technical skills and resources, and scarce evidence of safety and feasibility. The aim of this study is to present our experience with laparoscopy in trauma patients. METHODS:Retrospective chart review of consecutive patients admitted during a period of 7 years in a Trauma Center in Brazil. We included all patients initially managed by laparoscopy. Demographic, clinical, intra and postoperative data were analyzed. RESULTS:The analysis included 94 patients. Seventy-five were male (79%), mean age was 31 + 12 years-old. Blunt mechanism was present In 43 cases (45%). Mean ISS was 13.8. The most common indications for laparoscopy were free fluid with no parenchymal injuries in 28 cases (31.6%%) followed by thoracoabdominal penetrating injury (29.5%). Of the laparoscopic procedures, 70 were positive, of which 17 required conversion and 33 were completed laparoscopically. Main reasons for conversion were the need for bowel suture or resection, in 9 patients. There were no missed injuries. There were 4 Clavien > 3 complications. Unnecessary exploratory laparotomies were avoided in 93.7% of the patients.CONCLUSIONS: Laparoscopic management of trauma patients is feasible and safe when carefully selected. Absence of missed injuries and incidence of only low grade complications are important findings. Among the advantages of laparoscopy, the avoidance of unnecessary exploratory laparotomies, and their complications, should be highlighted.
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