Open Versus Laparoscopic Repair of Traumatic Diaphragmatic Injury: A Nationwide Propensity-Matched Analysis

Obaid, Omar; Hammad, Ahmed Mohammed Ali; Bible, Letitia; Ditillo, Michael; Castañón, Lourdes; Douglas, Molly; Anand, Tanya; Nelson, Adam; Joseph, Bellal

doi:10.1016/j.jss.2021.07.022

Cited by 5 publications

(11 citation statements)

References 17 publications

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“…Meta-analysis results suggested that the length of stay of patients who underwent laparoscopy was significantly shorter than those who underwent laparotomy [MD −3.83, 95% CI (−5.04, −2.62) days, p < 0.00001], there was high heterogeneity (I2 = 98%; see Figure 6A). Eight (7,18,28,31,32,36,37,39) of the ten remaining studies whose data was not suitable for quantitative synthesis were consistent with the above results, while the findings of two studies (19,21) did not favor the above results.…”

Section: Length Of Staysupporting

confidence: 63%

“…The literature search initially identified 1, 358 papers, of which 41 studies were eligible for the full-text screening process, and 23 studies (7,8,12,(17)(18)(19)(20)(21)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) were included in the metaanalysis. The PRISMA flow diagram is illustrated in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Four ( 33 , 34 , 37 , 41 ) of the 20 retrospective observational studies were based on controlled before and after study designs, while the remainder were comparative/parallel studies. Nine ( 7 , 8 , 12 , 18 , 19 , 21 , 36 , 39 , 40 ) of the 23 studies were focussed on therapeutic laparoscopy or reported separately on diagnostic laparoscopy. A total of 5,517 individual patients were involved in the study, with 2,594 patients enrolling in the laparoscopy group, and 2,923 patients in the laparotomy group.…”

Section: Resultsmentioning

confidence: 99%

“…Besides, the age did not differ significantly between the two intervention groups. Seventeen studies ( 7 , 8 , 12 , 18 , 19 , 21 , 27 , 30 – 32 , 34 , 36 – 41 ) reported the severity of the condition evaluated by the injury severity score, new injury severity score, or abbreviated injury scale/abdominal trauma index, while the six other studies ( 17 , 20 , 28 , 29 , 33 , 35 ) did not specify the severity scores at all. Additionally, in two studies, there was a significant difference in disease severity between the laparoscopy and laparotomy groups ( 12 , 32 ).…”

Section: Resultsmentioning

confidence: 99%

“…Soon after the laparoscopy procedure was introduced, several systematic reviews (14)(15)(16) summarizing its value for penetrating or blunt abdominal trauma were published. Subsequently, a series of papers (7,8,12,(17)(18)(19)(20)(21) were published addressing a wide range of possibilities for the application of laparoscopy in abdominal trauma. In this review, we integrated newly published studies with previous evidence to comprehensively compare the effectiveness and safety of laparoscopy with laparotomy on penetrating or blunt abdominal trauma.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis

Wang¹,

Cheng²,

Liu³

et al. 2022

Front. Surg.

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BackgroundThere is still no consensus regarding the role of laparoscopy in trauma cases. The purpose of this paper is to assess the value of diagnostic and therapeutic laparoscopy for patients with blunt or penetrating abdominal trauma by performing a systematic review and meta-analysis.MethodsPubMed, Embase, and the Cochrane library were systemically searched for the randomized controlled trials (RCTs) and non-RCT comparative studies on effectiveness and safety of laparoscopy vs. laparotomy for the two authors independently performed the search, data extraction, and quality assessment.ResultsA total of 5,517 patients were enrolled in 23 eligible studies that were published in English. Meta-analysis results suggest that there is no significant difference in the incidence of missed injury and mortality between abdominal trauma patients receiving laparoscopy and those receiving laparotomy. Concerning postoperative complications, compared with patients in the open surgery group, those in the laparoscopy group are at a similar risk of intra-abdominal abscesses, thromboembolism, and ileus, while there is a decreased incidence of wound infection and pneumonia. Besides, patients in the laparoscopy group experience shorter hospitalization times and procedure times. For most outcomes, the sensitivity analysis yielded similar results to the primary analysis.ConclusionLaparoscopic surgery is a practical alternative to laparotomy for appropriate patients. The decision to perform laparoscopy should be based on the experience of the surgeon and the resources available.

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