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Role of Laparoscopy in Patients With Abdominal Trauma at Level-I Trauma Center.
Parajuli, Purushottam; Kumar, Subodh; Gupta, Amit; Bansal, Virinder Kumar; Sagar, Sushma; Mishra, Biplab; Singhal, Maneesh; Kumar, Atin; Gamangatti, Shivanand; Gupta, Babita; Sawhney, Chhavi; Misra, Mahesh C.
Afiliación
  • Parajuli P; JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Surg Laparosc Endosc Percutan Tech ; 28(1): 20-25, 2018 Feb.
Article en En | MEDLINE | ID: mdl-28277439
INTRODUCTION: Abdominal trauma is one of the preventable causes of death in polytrauma patients. Decision and timing of laparotomy is a major challenge. Rate of nontherapeutic laparotomy is still high. Laparoscopy can avoid nontherapeutic laparotomy and also provide a reliable and accurate diagnosis of injury. MATERIALS AND METHODS: This ambispective observational study was conducted in the division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, All India Institute Medical Sciences, New Delhi. Retrospective analysis of prospectively maintained data of cases from January 1, 2008 through April 30, 2013 and prospective analysis of cases from May 1, 2013 through March 31, 2015 was done using appropriate measures. Hemodynamically stable or responders fulfilling inclusion criteria were included. Selected patients underwent the laparoscopic procedure and if required converted to laparotomy. RESULTS: Of the 3610 patients of abdominal trauma, laparotomy was done in 1666 (46.14%) patients and laparoscopy was done in 119 (3.29%) patients. Rate of reduction of nontherapeutic laparotomy in patients with abdominal trauma using diagnostic laparoscopy was 55.4%. However laparotomy could be avoided in 59.7%. Laparoscopy was 100% accurate in identifying injuries in our study. No injuries were missed in these patients. Fever and wound infection were significantly higher in laparotomy group. Chest infection and sepsis were also higher in laparotomy group but the difference was not statistically significant. Median length of hospital stay in laparoscopy group was 4 days (range: 1 to 28 d) and in laparotomy group was 9.5 days (range: 2 to 55 d) with P-value of 0.001. CONCLUSIONS: Laparoscopy has a role in management of hemodynamically stable patients with suspected abdominal injury to prevent nontherapeutic laparotomies, and thereby decreasing postoperative complications.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Centros Traumatológicos / Heridas Penetrantes / Laparoscopía / Traumatismos Abdominales Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Surg Laparosc Endosc Percutan Tech Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2018 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Centros Traumatológicos / Heridas Penetrantes / Laparoscopía / Traumatismos Abdominales Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Surg Laparosc Endosc Percutan Tech Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2018 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos