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Is the minimally invasive trauma surgeon the next (r)evolution of trauma surgery? Indications and outcomes of diagnostic and therapeutic trauma laparoscopy in a level 1 trauma centre.
- Source :
-
Updates in surgery [Updates Surg] 2020 Jun; Vol. 72 (2), pp. 503-512. Date of Electronic Publication: 2020 Mar 26. - Publication Year :
- 2020
-
Abstract
- The aim of this study was to evaluate the trend in use, feasibility and safety of laparoscopy in a single level 1 European trauma centre. Laparoscopy in abdominal trauma is gaining acceptance as a diagnostic and a therapeutic tool as it reduces surgical invasiveness and may reduce post-operative morbidity. All trauma patients who underwent a laparoscopic procedure between January 2013 and December 2017 were retrospectively analysed. A sub-analysis of isolated abdominal trauma was also performed. There has been a significant increase in the use of this technique in the considered time period. A total of 40 patients were included in the study: 17 diagnostic laparoscopies and overall 32 therapeutic laparoscopies. Conversion rate was 15%. All patients were hemodynamically stable. The majority of patients were younger than 60 years, with an ASA score of I-II and sustained a blunt trauma. Mean ISS score was 17. Colon and diaphragm were the most commonly laparoscopically diagnosed injuries, while splenectomy was the most common operation. The average operating time was 106 min. There were no missed injuries, no SSI, no re-interventions and no mortality related to the surgical procedure. The average length of stay was 14 days. No significant difference was found in the isolated abdominal trauma group. Laparoscopy is an emergent safe and effective technique for both diagnostic and therapeutic purposes in selected stable abdominal penetrating or blunt trauma patients. However, these results need to be put in relation with the level of the centre and the expertise of the surgeon.
- Subjects :
- Abdominal Injuries diagnosis
Adult
Aged
Aged, 80 and over
Europe
Feasibility Studies
Female
Humans
Laparoscopy statistics & numerical data
Length of Stay
Male
Middle Aged
Morbidity
Operative Time
Postoperative Complications epidemiology
Postoperative Complications prevention & control
Retrospective Studies
Safety
Young Adult
Abdominal Injuries surgery
Laparoscopy methods
Laparoscopy trends
Minimally Invasive Surgical Procedures trends
Procedures and Techniques Utilization statistics & numerical data
Procedures and Techniques Utilization trends
Surgeons
Trauma Centers
Subjects
Details
- Language :
- English
- ISSN :
- 2038-3312
- Volume :
- 72
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Updates in surgery
- Publication Type :
- Academic Journal
- Accession number :
- 32219731
- Full Text :
- https://doi.org/10.1007/s13304-020-00739-0