1887
Volume 2022, Issue 5
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Exploratory laparotomy has been the standard intervention for surgical evaluation or treatment of abdominal trauma. Laparoscopic surgery with its proposed favorable surgical outcome may provide a reliable and accurate diagnosis of the injury. In this study, we aim to define the diagnostic role of laparoscopy in abdominal trauma and define the proposed advantages of reducing nontherapeutic laparotomies. The study is a cohort retrospective study conducted at a level I trauma center – Rashid Hospital, United Arab Emirates. All patients from January 2016 to May 2019 with a history of abdominal trauma requiring surgical intervention fulfilling the inclusion criteria were included. The outcome of this study was to look at the rate of reduction of nontherapeutic laparotomies and the rate of missed injury. The rate of reduction of nontherapeutic laparotomy in patients with abdominal trauma using diagnostic laparoscopy was 19.4%. Post-operative complications were higher in the open exploration group (p-value = 0.04). No missed injury was reported among the laparoscopy group. The mean hospital stay was higher in the laparotomy group compared to the laparoscopy group (13.6 vs 17.1). Laparoscopy was successful in 68.4% of the patients and the conversion rate was 31.6%. Laparoscopy has a role in the diagnosis of intra-abdominal injuries of hemodynamically stable patients with suspected abdominal injury to reduce unnecessary laparotomies, thereby decreasing postoperative complications.

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2022-11-14
2024-04-21
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References

  1. Søreide K. Epidemiology of major trauma. Br J Surg. 2009 Jul;96:(7):697–8. doi: 10.1002/bjs.6643.
    [Google Scholar]
  2. Smith J, Caldwell E, D’Amours S, Jalaludin B, Sugrue M. Abdominal trauma: a disease in evolution. ANZ J Surg. 2005 Sep;75:(9):790–4. doi: 10.1111/j.1445-2197.2005.03524.x.
    [Google Scholar]
  3. Watts DD, Fakhry SM; EAST Multi-Institutional Hollow Viscus Injury Research Group. Incidence of hollow viscus injury in blunt trauma: an analysis from 275,557 trauma admissions from the East multi-institutional trial.J Trauma. 2003 Feb;54:(2):289–94.
    [Google Scholar]
  4. Lefeling R, Paffrath T, Nienaber U. Annual Report 2015 Trauma Register DGU [Internet]. Trauma Register. 2015 [cited 22 May 2016]. Available from: https://www.traumaregister-dgu.de/fileadmin/user_upload/TR-DGU_annual_report_2015.pdf
    [Google Scholar]
  5. Zantut LF, Ivatury RR, Smith RS, Kawahara NT, Porter JM, Fry WR, et al. Diagnostic and therapeutic laparoscopy for penetrating abdominal trauma: a multicenter experience. J Trauma. 1997 May;42:(5):825–9;discussion 829-31. doi: 10.1097/00005373-199705000-00012.
    [Google Scholar]
  6. Smith RS, Fry WR, Morabito DJ, Koehler RH, Organ CH Jr. Therapeutic laparoscopy in trauma. Am J Surg. 1995 Dec;170:(6):632-6; discussion 636-7. doi: 10.1016/s0002-9610(99)80031-2.
    [Google Scholar]
  7. Chen RJ, Fang JF, Lin BC, Hsu YB, Kao JL, Kao YC, Chen MF. Selective application of laparoscopy and fibrin glue in the failure of nonoperative management of blunt hepatic trauma. J Trauma. 1998 Apr;44:(4):691–5. doi: 10.1097/00005373-199804000-00024.
    [Google Scholar]
  8. Chol YB, Lim KS. Therapeutic laparoscopy for abdominal trauma. Surg Endosc. 2003 Mar;17:(3):421–7. doi: 10.1007/s00464-002-8808-8.
    [Google Scholar]
  9. Mathonnet M, Peyrou P, Gainant A, Bouvier S, Cubertafond P. Role of laparoscopy in blunt perforations of the small bowel. Surg Endosc. 2003 Apr;17:(4):641–5. doi: 10.1007/s00464-002-9049-6.
    [Google Scholar]
  10. Martin MJ, Brown CVR, Shatz DV, Alam HB, Brasel KJ, Hauser CJ, et al. Evaluation and management of abdominal stab wounds: A Western Trauma Association critical decisions algorithm. J Trauma Acute Care Surg. 2018 Nov;85:(5):1007–1015. doi: 10.1097/TA.0000000000001930.
    [Google Scholar]
  11. Virmani V, George U, MacDonald B, Sheikh A. Small-bowel and mesenteric injuries in blunt trauma of the abdomen. Can Assoc Radiol J. 2013 May;64:(2):140–7. doi: 10.1016/j.carj.2012.10.001.
    [Google Scholar]
  12. Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992 Oct;13:(10):606–8.
    [Google Scholar]
  13. Ertekin C, Yanar H, Taviloglu K, Güloglu R, Alimoglu O. Unnecessary laparotomy by using physical examination and different diagnostic modalities for penetrating abdominal stab wounds. Emerg Med J. 2005 Nov;22:(11):790–794. doi: 10.1136/emj.2004.020834
    [Google Scholar]
  14. Wise R, Faurie M, Malbrain M, Hodgson E. Strategies for Intravenous Fluid Resuscitation in Trauma Patients. World Journal of Surgery. 2017;41:(5):1170–1183.
    [Google Scholar]
  15. Rothrock J, Seifert P. Assisting in surgery. Denver: Competency & Credentialing Institute; 2009.
    [Google Scholar]
  16. Katagiri H, Okumura K, Machi J. Internal hernia due to mesenteric defect.Journal of Surgical Case Reports. 2013;2013:(5):rjt037-rjt037.
    [Google Scholar]
  17. AlGorashi W, Al Zahidy Z, Sharton A, Turki S, Aljiffry A, Al-jehani A, et al. Prevalence of Internal Hernia Post Laparoscopic Surgery. The Egyptian Journal of Hospital Medicine. 2017;66:(1):166-169. doi: 10.12816/0034649
    [Google Scholar]
  18. Buia A, Stockhausen F, Hanisch E. Laparoscopic surgery: A qualified systematic review. World J Methodol. 2015 Dec 26;5:(4):238-54. doi: 10.5662/wjm.v5.i4.238.
    [Google Scholar]
  19. Ivatury RR, Simon RJ, Stahl WM. A critical evaluation of laparoscopy in penetrating abdominal trauma. J Trauma. 1993 Jun;34:(6):822–7; discussion 827-8. doi: 10.1097/00005373-199306000-00013.
    [Google Scholar]
  20. Wang J, Cheng L, Liu J, Zhang B, Wang W, Zhu W et al. Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis.Frontiers in Surgery. 2022;9::127–136.
    [Google Scholar]
  21. Lim KH, Chung BS, Kim JY, Kim SS. Laparoscopic surgery in abdominal trauma: a single center review of a 7-year experience. World J Emerg Surg. 2015 Mar 12;10::16. doi: 10.1186/s13017-015-0007-8.
    [Google Scholar]
  22. Kawahara NT, Alster C, Fujimura I, Poggetti RS, Birolini D. Standard examination system for laparoscopy in penetrating abdominal trauma. J Trauma. 2009 Sep;67:(3):589–95. doi: 10.1097/TA.0b013e3181a60593.
    [Google Scholar]
  23. Parajuli P, Kumar S, Gupta A, Bansal VK, Sagar S, Mishra B, et al. Role of Laparoscopy in Patients With Abdominal Trauma at Level-I Trauma Center. Surg Laparosc Endosc Percutan Tech. 2018 Feb;28:(1):20–25. doi: 10.1097/SLE.0000000000000379.
    [Google Scholar]
  24. Berci G, Sackier JM, Paz-Parlow M. Emergency laparoscopy. Am J Surg. 1991;161::332–335.
    [Google Scholar]
  25. Renz BM, Feliciano DV. Unnecessary laparotomies for trauma: a prospective study of morbidity. J Trauma. 1995 Mar;38:(3):350–6. doi: 10.1097/00005373-199503000-00007.
    [Google Scholar]
  26. Barzana DC, Kotwall CA, Clancy TV, Hope WW. Use of laparoscopy in trauma at a level II trauma center. JSLS. 2011 Apr-Jun;15:(2):179-81. doi: 10.4293/108680811X13071180406358.
    [Google Scholar]
  27. Matsevych OY, Koto MZ, Motilall SR, et al. The role oflaparoscopy in management of stable patients with penetrating abdominal trauma and organ evisceration. J Trauma Acute Care Surg. 2016;81::307–311.
    [Google Scholar]
  28. Li Y, Xiang Y, Wu N, Wu L, Yu Z, Zhang M, et al. A Comparison of Laparoscopy and Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-analysis. World J Surg. 2015 Dec;39:(12):2862–71. doi: 10.1007/s00268-015-3212-4.
    [Google Scholar]
  29. Zafar SN, Onwugbufor MT, Hughes K, et al. Laparoscopic surgery for trauma: the realm of therapeutic management. Am J Surg. 2015;209:(4):627–632.
    [Google Scholar]
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