Yunhe Gao1, Jianxin Cui1, Zhi Qiao1, Shibo Bian2, Feide Liu3, Kecheng Zhang1, Yi Liu1, Yixun Lu1, Shaoqing Li1, Xinxin Wang1, Hongqing Xi1, Lin Chen1. 1Chinese PLA General Hospital, 2Beijing Friendship Hospital, 3The First Affiliated Hospital of the PLA General Hospital
Background: Laparoscopy is increasingly applied in the management of abdominal trauma as either diagnostic or therapeutic interventions recently. However, the clinical outcomes remained unclear, especially when comparing with conventional laparotomy.
Methods: Fifty-two patients undergoing laparoscopic intervention (LAP) for abdominal trauma in three medical centers in China between January 2008 to January 2018 were consecutively enrolled in the analysis cohort. Another cohort of 52 patients for laparotomy (LAT) were matched according to patient baseline characteristics, severity of injuries and hemodynamic compromise. Perioperative clinical parameters and short-term survival were compared between these two groups.
Results: The baseline characteristics were comparable between these two groups (Age: LAP vs LAT: 38.9±16.1 vs 34.2±18.0, p=0.082). The most common cause was traffic accident and the most frequent surgical intervention was bowel repair/resection in both groups. The laparoscopic surgery showed comparable detection power (Sensitivity, LAP vs LAT: 92.3% vs 98.1%, p=0.203) and the operation time was similar in these two groups (LAP vs LAT: 90.3±56.8 vs 78.1±47.7 min, p=0.119) . Post-operative complication rate was less (7.7% vs 13.5%, p=0.519) and the analgesia application was reduced in the LAP group (Median requirement: 51 vs 125 morphine equivalents (MEQ), p<0.05). The hospital stay was significantly shorter in the LAP group (5.9±3.7 vs 8.0±5.4 days, p=0.01). The one-year follow-up showed similar overall survival rate and no trauma-related death occurred in both groups.
Conclusion: Laparoscopy is feasible and safe in treating abdominal trauma patients in hemodynamically stable conditions performed by experienced surgeons. The laparoscopy intervention might have the advantages of lower complication rate, reduced pain and quick recovery with similar favorable clinical outcomes.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93902
Program Number: S141
Presentation Session: Acute Care
Presentation Type: Podium