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Trauma Laparoscopy: Time Efficient, Cost Effective, and Safe.
Dorricott, Alexa R; Dickinson, Abigail; McNickle, Allison G; Batra, Kavita; Flores, Carmen E; Fraser, Douglas R; Chestovich, Paul J.
Afiliación
  • Dorricott AR; Department of Surgery, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada.
  • Dickinson A; Department of Surgery, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada.
  • McNickle AG; Department of Surgery, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada. Electronic address: allison.mcnickle@unlv.edu.
  • Batra K; Office of Research, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada.
  • Flores CE; Department of Surgery, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada.
  • Fraser DR; Department of Surgery, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada.
  • Chestovich PJ; Department of Surgery, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada.
J Surg Res ; 301: 455-460, 2024 Jul 20.
Article en En | MEDLINE | ID: mdl-39033596
ABSTRACT

INTRODUCTION:

Laparoscopy has demonstrated improved outcomes in abdominal surgery; however, its use in trauma has been less compelling. In this study, we hypothesize that laparoscopy may be observed to have lower costs and complications with similar operative times compared to open exploration in appropriately selected patients.

METHODS:

We retrospectively reviewed adult patients undergoing abdominal exploration after blunt and penetrating trauma at our level 1 center from 2008 to 2020. Data included mechanism, operative time, length of stay (LOS), hospital charges, and complications. Patients were grouped as follows therapeutic and nontherapeutic diagnostic laparoscopy and celiotomy. Therapeutic procedures included suture repair of hollow viscus organs or diaphragm, evacuation of hematoma, and hemorrhage control of solid organ or mesenteric injury. Unstable patients, repair of major vascular injuries or resection of an organ or bowel were excluded.

RESULTS:

Two hundred ninety-six patients were included with comparable demographics. Diagnostic laparoscopy had shorter operative times, LOS, and lower hospital charges compared to diagnostic celiotomy controls. Similarly, therapeutic laparoscopy had shorter LOS and lower hospital costs compared to therapeutic celiotomy. The operative time was not statistically different in this comparison. Patients in the celiotomy groups had more postoperative complications. The differences in operative time, LOS and hospital charges were not statistically significant in the diagnostic laparoscopy compared to diagnostic laparoscopy converted to diagnostic celiotomy group, nor in the therapeutic laparoscopy compared to the diagnostic laparoscopy converted to therapeutic laparoscopy group.

CONCLUSIONS:

Laparoscopy can be used safely in penetrating and blunt abdominal trauma. In this cohort, laparoscopy was observed to have shorter operative times and LOS with lower hospital charges and fewer complications.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Surg Res Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Surg Res Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos