General approach to penetrating abdomen traumas of Turkish General Surgeons: Survey of practice

Karateke, Faruk; Ozyazici, Sefa; Daş, Koray; Menekse, Ebru; Önel, Safa; Özdoğan, Mehmet; Özmen, Mehmet Mahir; Agalar, Fatih; Ertekın, Cemalettın

doi:10.5505/tjtes.2013.76281

Cited by 1 publication

(2 citation statements)

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“…The goal of SNOM in penetrating abdominal traumas is to reduce unnecessary laparotomies and associated complications and to shorten the duration of hospitalization. [2,5] Studies have shown that unnecessary laparotomy leads to various complications up to 41% and extend the duration of hos- pitalization in patients with abdominal penetrating traumas. [6][7][8] In the present study, we found that the duration of hospitalization was shorter in patients who underwent SNOM compared to patients who underwent negative laparotomy (3.41±2.67 vs. 7.16±4.70 days).…”

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confidence: 99%

“…In several surveys conducted among surgeons in our country and other countries around the world, at least half of surgeons did not find SNOM as a safe and effective method in AGSW. [2][3][4] INTRODUCTION While mandatory explorative laparotomy has been performed in penetrating abdominal traumas in the first half of the 20 th century, selective non-operative management (SNOM) became a current issue and was introduced especially in abdominal stab wounds (ASW) after a study published by Shaftan in 1960. Later, in 1974, Nance et al reported that SNOM is a safe and effective method in abdominal gunshot wounds (AGSW).…”

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confidence: 99%

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Non-operative management of civilian abdominal gunshot wounds

Özpek

Canbak

2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:In this study, we aimed to evaluate the results of selective non-operative management in patients with civilian abdominal gunshot wounds. METHODS:Patients hospitalized and monitored in our clinic due to civilian abdominal gunshot wounds between January 2009 and January 2018 were retrospectively examined. Patients were studied concerning age, gender, mechanism of injury, anatomic injury site, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), Revised Trauma Score (RTS), treatment method, time to operation, days of hospitalization and mortality. RESULTS:Of the patients, 84 (89.4%) were male, and 10 (10.6%) were female with a mean age of 32.7 (range 4-60). The mean ISS, RTS and PATI values of all patients were 17.05, 7.27 and 9.21, respectively. Immediate laparotomy and/or thoracotomy were performed in 21 (22.3%) of the patients due to hemodynamic instability and in 27 (28.7%) of the patients because of peritonitis findings. The remaining 46 (48.9%) patients were managed non-operatively. Among these patients, early laparotomy was performed in five (5.3%) and late laparotomy in eight (8.5%) patients who developed peritonitis symptoms. The other 33 (35.1%) patients were treated non-operatively. Of these patients, 61.1% of the patients with flank injuries, 50% of the patients with right thoracoabdominal injuries, 44.4% of the patients with posterior abdominal injuries, 42.1% of the patients with pelvic injuries and 27.8% of the patients with left thoracoabdominal injuries were successfully treated non-operatively. Non-therapeutic or negative laparotomy was performed on six (6.4%) patients. Mortality was 10.6% (n=10) in all patients.CONCLUSION: Some patients with a civilian abdominal gunshot wound in certain anatomical localization who are hemodynamically stable and have no peritonitis symptoms can be non-operatively managed just as in patients with abdominal stab wounds. Success rates of selective non-operative management are high, especially in gunshot wounds of flank, posterior abdominal, thoracoabdominal and pelvic regions.

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