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

• Published in: The American journal of surgery 2015-08, Vol.210 (2), p.326-333
• Main Authors: Lin, Heng-Fu, M.D, Chen, Ying-Da, M.D, Lin, Keng-Li, M.D, Wu, Meng Che, M.D, Wu, Cheng Yi, M.D, Chen, Shyr-Chyr, M.D., E.M.B.A
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Antibiotics; Blood pressure; Blunt hollow viscus and mesenteric injuries; Diagnostic laparoscopy; Female; Hemodynamics; Hospitals; Humans; Injuries; Intervention; Laparoscopy; Laparotomy; Laparotomy - statistics & numerical data; Male; Medical diagnosis; Medical imaging; Mesentery - injuries; Mortality; Ostomy; Patients; Postoperative period; Retrospective Studies; Surgery; Therapeutic laparoscopy; Viscera - injuries; Wounds, Nonpenetrating - diagnosis; Wounds, Nonpenetrating - physiopathology; Wounds, Nonpenetrating - surgery
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2014.11.009

Abstract 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.