1. Laparoscopy has a therapeutic role in the management of abdominal trauma: A matched-pair analysis
- Author
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Chakravartty, Saurav, Patel, Ameet, Sarma, Diwakar R., Noor, Muhammad, Panagiotopoulos, Spyros, and Patel, Ameet G.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Matched Pair Analysis ,Adolescent ,Matched-Pair Analysis ,medicine.medical_treatment ,Operative Time ,laparoscopy ,Hemodynamics ,Abdominal Injuries ,Young Adult ,03 medical and health sciences ,Injury Severity Score ,Postoperative Complications ,0302 clinical medicine ,Laparotomy ,medicine ,Operating time ,Humans ,abdominal trauma ,Laparoscopy ,therapeutic laparoscopy ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,General Medicine ,Length of Stay ,Middle Aged ,medicine.disease ,Surgery ,trauma ,Abdominal trauma ,030220 oncology & carcinogenesis ,Radiological weapon ,Female ,030211 gastroenterology & hepatology ,business - Abstract
Introduction: Laparoscopy is increasingly utilised as a diagnostic tool in management of abdominal trauma; however its role in therapeutic intervention remains unexplored. The aim of this study is to compare laparoscopy with laparotomy in the treatment of abdominal trauma in haemodynamically stable patients. Methods: A review of patients undergoing surgery for abdominal trauma between January 2004-2014 identified 25 patients who underwent laparoscopy for therapeutic intervention (TL). This group was matched with 25 similar patients undergoing laparotomy (LT). Matching of the two cohorts was based on patient characteristics, severity of injuries, haemodynamic compromise and radiological findings. Peri-operative outcomes were compared. Discussion: patient characteristics were similar in TL and LT patients for age (median 33 vs. 26 years), gender distribution and clinical presentation. Injury severity score was also similar with a median of 16 in both groups (major trauma=ISS>15, normal range 0-75). Types of injuries included; hollow viscus [bowel repair = 10 (TL) vs. 17 (LT)] and solid organs [5(TL) vs. 2 (LT)]. Median operating time was similar in both groups; 105(TL) compared to 98 (LT) minutes (p=0.09). Post-operative complications (1 vs. 10, p < 0.001), analgesia requirements, specifically opiate use (34 vs. 136 morphine equivalents, pConclusions: Abdominal trauma in haemodynamically stable patients can be managed effectively and safely with laparoscopy by experienced surgeons. Major benefits may include lower morbidity, reduced pain, and shorter length of hospital stay.
- Published
- 2017