The utility of diagnostic laparoscopy in the evaluation of anterior abdominal stab wounds

被引：15

作者：

Kopelman, Tammy R. ^{[1
]}

O'Neill, Patrick J. ^{[1
]}

Macias, Luis H. ^{[1
]}

Cox, Jordy C. ^{[1
]}

Matthews, Marc R. ^{[1
]}

Drachman, David A. ^{[2
]}

机构：

[1] Maricopa Cty Gen Hosp, Dept Surg, Div Burns Trauma Surg & Surg Crit Care, Phoenix, AZ 85008 USA

[2] Maricopa Cty Gen Hosp, Dept Res, Phoenix, AZ 85008 USA

来源：

AMERICAN JOURNAL OF SURGERY | 2008年 / 196卷 / 06期

关键词：

Anterior abdominal stab wounds; Diagnostic laparoscopy; Computed tomography; Diagnostic peritoneal lavage; Hospital charges; Laparotomy; Length of stay; Local wound exploration; Nontherapeutic; Serial abdominal examinations; Therapeutic;

D O I：

10.1016/j.amjsurg.2008.07.031

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: To assess if diagnostic laparoscopy (DL) is superior to nonoperative modes (serial abdominal examination with/without computed axial tomography [CAT] and diagnostic peritoneal lavage) in determining the need for therapeutic laparotomy (TL) after anterior abdominal stab wound (ASW). METHODS: Retrospective review of ASW patients. Patients were divided into group A (DL/exploratory laparotomy) to identify peritoneal violation (PV) and group B (initial nonoperative modes). RESULTS: Seventy-three patients met inclusion criteria. In group A (n = 38), 29 patients (76%) had PV by DL and underwent exploratory laparotomy. Only 10 (35%) underwent TL (sensitivity for PV = 100%; specificity and positive predictive value of PV in determining need for TL = 29% and 33%, respectively). In group B (n = 35), 7 patients (20%) underwent TL, yielding an improved specificity (96%) and positive predictive value (88%). CONCLUSIONS: We find no role for DL in the evaluation of ASW patients solely to determine PV. (C) 2008 Elsevier Inc. All rights reserved.

引用

页码：871 / 877

页数：7

共 29 条

[1] NEPHROTOXICITY OF CONTRAST-MEDIA [J].

BERNS, AS ;

KANTER, A ;

COHEN, JJ ;

GARELLA, S ;

SIMON, N ;

DUFFY, B ;

SPRAGUE, S ;

LAU, K .

KIDNEY INTERNATIONAL, 1989, 36 (04) :730-740

[2] Performance of CT in detection of bowel injury [J].

Butela, ST ;

Federle, MP ;

Chang, PJ ;

Thaete, FL ;

Peterson, MS ;

Dorvault, CJ ;

Hari, AK ;

Soni, S ;

Branstetter, BF ;

Paisley, KJ ;

Huang, LF .

AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 176 (01) :129-135

[3]

Cayten C. Gene, 1996, P281

[4] The role of laparoscopy in penetrating abdominal stab wounds [J].

Cherry, RA ;

Eachempati, SR ;

Hydo, LJ ;

Barie, PS .

SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 2005, 15 (01) :14-17

[5]

COMO JJ, 2007, PRACTICE MANAGEMENT

[6] INDICATIONS FOR OPERATION IN ABDOMINAL STAB WOUNDS - A PROSPECTIVE-STUDY OF 651 PATIENTS [J].

DEMETRIADES, D ;

RABINOWITZ, B .

ANNALS OF SURGERY, 1987, 205 (02) :129-132

[7] Laparoscopy for triage of penetrating trauma: The decision to explore [J].

Ditmars, ML ;

Bongard, F .

JOURNAL OF LAPAROENDOSCOPIC SURGERY, 1996, 6 (05) :285-291

[8] Unnecessary laparotomy by using physical examination and different diagnostic modalities for penetrating abdominal stab wounds [J].

Ertekin, C ;

Yanar, H ;

Taviloglu, K ;

Güloglu, R ;

Alimoglu, O .

EMERGENCY MEDICINE JOURNAL, 2005, 22 (11) :790-794

[9] A PROSPECTIVE ANALYSIS OF DIAGNOSTIC LAPAROSCOPY IN TRAUMA [J].

FABIAN, TC ;

CROCE, MA ;

STEWART, RM ;

PRITCHARD, FE ;

MINARD, G ;

KUDSK, KA .

ANNALS OF SURGERY, 1993, 217 (05) :557-565

[10] Emergency laparoscopy for abdominal stab wounds [J].

Hallfeldt, KKJ ;

Trupka, AW ;

Erhard, J ;

Waldner, H ;

Schweiberer, L .

SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 1998, 12 (07) :907-910

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