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

• Published in: PloS one Vol. 13; no. 2; p. e0193379
• Main Authors: Lin, Heng-Fu, Chen, Ying-Da, Chen, Shyr-Chyr
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 22.02.2018; Public Library of Science (PLoS)
• Subjects: Abdomen; Biology and Life Sciences; Blood; Blood pressure; Blood transfusion; Brain; Complications; Diagnosis; Diagnostic systems; Emergency medical care; Head injuries; Health care facilities; Health care industry; Health services; Hospitals; Injuries; Laparoscopy; Medical diagnosis; Medical services; Medicine; Medicine and Health Sciences; Patients; People and Places; Performance evaluation; Spleen; Surgeons; Surgery; Transfusion; Trauma; Traumatic brain injury; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0193379

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.