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Impact of laparoscopic approach in emergency major abdominal surgery: single-centre analysis of 748 consecutive cases.
- Source :
-
Annals of the Royal College of Surgeons of England [Ann R Coll Surg Engl] 2018 Apr; Vol. 100 (4), pp. 279-284. Date of Electronic Publication: 2018 Jan 24. - Publication Year :
- 2018
-
Abstract
- Background Acute abdominal pathology requiring emergency laparotomy is a common surgical presentation. Despite its widespread implementation in other surgical procedures, laparoscopy, rather than laparotomy, is sparingly used in major emergency surgery. This study reports outcomes and impact of rising use of laparoscopy for a single high-volume district general hospital. Methods Data were retrieved from the prospective National Emergency Laparotomy Audit database for a 30-month period. Patient, procedural, and in-hospital outcome data were collated. Temporal trends were assessed and regression analysis conducted for clinical outcomes. Results A total of 748 consecutive cases were recorded. There was an increasing use of laparoscopy over the study period, with 49% of cases attempted laparoscopically in the final six-month interval. Patients treated laparoscopically were at reduced risk of mortality (odds ratio 0.114, 95% confidence interval 0.024 to 0.550) and experienced reduced length of intensive care stay (regression coefficient –1.571, 95% confidence interval –2.625 to –0.517) in multivariate adjusted analysis. Conclusions Laparoscopy is safe and feasible in a large proportion of cases. It is associated with improved outcomes versus laparotomy.
- Subjects :
- Adult
Aged
Aged, 80 and over
Emergency Medical Services methods
Emergency Medical Services standards
Emergency Medical Services trends
Feasibility Studies
Female
Hospital Mortality
Humans
Intensive Care Units statistics & numerical data
Laparoscopy methods
Laparoscopy mortality
Laparoscopy trends
Length of Stay statistics & numerical data
Male
Middle Aged
Practice Guidelines as Topic
Prospective Studies
Treatment Outcome
Young Adult
Abdomen, Acute surgery
Emergency Medical Services statistics & numerical data
Laparoscopy statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1478-7083
- Volume :
- 100
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Annals of the Royal College of Surgeons of England
- Publication Type :
- Academic Journal
- Accession number :
- 29364016
- Full Text :
- https://doi.org/10.1308/rcsann.2017.0229