Laparoscopic Management of Left Thoracoabdominal Stab Wounds: A Prospective Study

Abstract

Laparotomy was required in only 11.1% (4/36) of the cases with LTSWs and 30.8% (4/13) of the cases with diaphragmatic injury. Diagnostic and therapeutic laparoscopy was a sufficient and necessary surgical procedure in cases with a hemodynamically stable LTSW, when emergency surgery (laparotomy or thoracotomy) was not necessary.

A Left Hemithorax Mystery

“…This approach is supported by a recent study that reported a high prevalence of diaphragmatic or intra-abdominal injuries in such patients, and demonstrated the possibility of laparoscopic repair during the same session [3] .…”

“…expiration. Injuries to the diaphragm can be expected in more than 30% of patients with penetrating trauma to the thoracoabdominal area [3] . The diagnosis may not be apparent immediately and is missed initially in more than a third of the patients [4] .…”

Importance of diagnostic laparoscopy in the assessment of the diaphragm after left thoracoabdominal stab wounds: A Prospective cohort study

“…[4,[6][7][8]17,21,24,25] Diaphragm injury rates have been reported in range of 10% to 50% in several studies that investigated left thoracoabdominal stab injuries using diagnostic laparoscopy. [1][2][3][4][5]8,22,26,27] In the present study, diaphragm injury rate was 23.5% in all patients and 22.1% in patients who underwent diagnostic laparoscopy. Early diagnosis of diaphragm injuries in left thoracoabdominal stab injuries is challenging based on physical examination, chest X-ray, ultrasonography, and tomography.…”

Diaphragmatic Injury: Condition be noticed in the management of thoracic trauma

“…Diyafragma yaralanmalarında laparoskopi gibi video yardımlı torakoskopi de tanı ve tedavide başarıyla kullanılmaktadır. [19,20] Akut yaralanmada diyafragma bütünlüğü bozulmadıysa non-absorbabl (0 veya 1 numara) sütür kullanılmalıdır. Ancak geniş defekt veya kronik olguda defekti güçlendirmek için prostetik meş ile desteklenmelidir.…”