Value of diagnostic and therapeutic laparoscopy for patients with blunt abdominal trauma: A 10-year medical center experience

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.

The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis

“…However, recent studies are more in the realm of therapeutic laparoscopy, contributing to decreasing conversion rate. They included laparoscopic procedures such as bowel resection, bowel repair, bladder repair, splenectomy, distal pancreatectomy, diaphragm repair, and hemostasis [15,16,18,20,21,23]. In early studies, laparotomy was needed for these procedures.…”

“…In terms of study design and anatomic location of trauma, there was substantial heterogeneity across the studies (Table 1). Fabian [6] 1993 Townsend [7] 1993 Taner [8] 2001 Mathonnet [9] 2003 Omori [10] 2003 Mitsuhide [11] 2005 Huscher [12] 2006 Kaban [13] 2008 Mallat [14] 2008 Shah [15] 2011 Johnson [16] 2013 Memon [18] 2013 Khubutiya [17] 2013 Huang [19] 2017 Koto [23] 2018 Parajuli [22] 2017 Lin [20] 2018 Matsevych [21] 2018 Nicolau [24] 2019 NOS, Newcastle-Ottawa scale; NRS, non-randomized study; , The study has met the criteria for a domain of the Newcastle-Ottawa Scale.…”

Improved access in minimally invasive temporomandibular joint surgery through a novel endaural template

“…Minimally invasive surgery is widely utilized and sometimes regarded as the gold standard of treatment in several fields of medicine [ 7 – 9 ]. However, it is difficult in TMJ surgery due to the close proximity of anatomical structures.…”

Laparoscopic treatment of mesenteric avulsion and intestinal perforation after blunt abdominal trauma: A report of a case

“…Emergency surgery must be considered especially in severe hypotension associated with positive FAST, evisceration, haemodynamic instability or diffuse peritonitis, and laparotomy has been considered the standard procedure for these cases. Laparoscopic surgery can be a valid alternative both for diagnostic and for therapeutic purpose only in haemodynamically stable patients [ 30 ]. In patients with no indication for immediate laparotomy with clinical status suspected for mesenteric or hollow viscus injury laparoscopy can be used as a complementary diagnostic device to carry out an exploration of abdominal cavity, to check bowel perfusion, and eventually to resect affected bowel segments [ 31 ].…”