Laparoscopy decreases the laparotomy rate for hemodynamically stable patients with blunt hollow viscus and mesenteric injuries

被引：30
|
作者：
Lin, Heng-Fu [1 ,2 ,3 ]
Chen, Ying-Da [1 ]
Lin, Keng-Li [1 ]
Wu, Meng Che [2 ,3 ]
Wu, Cheng Yi [2 ,3 ]
Chen, Shyr-Chyr [2 ,3 ]
机构：
[1] Far Eastern Mem Hosp, Dept Surg, Taipei, Taiwan
[2] Natl Taiwan Univ Hosp, Dept Emergency Med, Taipei, Taiwan
[3] Natl Taiwan Univ, Coll Med, Taipei 10764, Taiwan
来源：
AMERICAN JOURNAL OF SURGERY | 2015年 / 210卷 / 02期
关键词：
Laparoscopy; Diagnostic laparoscopy; Therapeutic laparoscopy; Blunt hollow viscus and mesenteric injuries; Laparotomy; DIAGNOSTIC PERITONEAL-LAVAGE; SOLID-ORGAN INJURY; ABDOMINAL-TRAUMA; COMPUTED-TOMOGRAPHY; FREE FLUID; NONOPERATIVE MANAGEMENT; OPEN APPENDECTOMY; SMALL-BOWEL; DELAY;
D O I：
10.1016/j.amjsurg.2014.11.009
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
BACKGROUND: The aim of this study was to evaluate the effect of laparoscopy on patients with blunt hollow viscus and mesenteric injuries (BHVMIs). METHODS: Hemodynamically stable patients with BHVMIs were diagnosed using computed tomography and serial examinations. Patients admitted from July 1, 1999 to June 30, 2006 underwent exploratory laparotomy (group A), and those admitted from January 1, 2007 to December 31, 2013 received laparoscopy (group B). RESULTS: There were 62 patients in group A, and 59 patients in group B. There were no significant differences in demographic characteristics, injury severity score, and injuries requiring surgical intervention between the groups (all, P > . 05). Patients in group B had a shorter hospital stay (mean 11.0 vs 17.6 days, P < .001) and lower wound infection rate (mean 5.1% vs 16.1%, P = .049). The conversion rate of laparoscopy to laparotomy in group B was 8.5%, compared with a 100% laparotomy rate in group A (P < .001). There was no difference in the complication rate between groups. CONCLUSION: Laparoscopy is feasible and safe for hemodynamically stable patients with BHVMIs. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码：326 / 333
页数：8
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