Clinical Significance of Laparoscopy in Abdominal Trauma: Report of 65 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHOUZhi-gang ¹ , QIZhen-cai ¹ , LIHeng-ping ¹ ,  CHENGuo-ting ²

1. Department of General Surgery, Affiliated Laigang Hospital, Taishan Medical College, Laiwu 271104, Shandong Province, China;
2. Emergency Trauma Center, Affiliated East Hospital, Tongji University of Medical School, Shanghai 200120, China;

Corresponding author：

CHENGuo-ting, Email: guotingchen@163.com

Keywords：

Abdominal trauma; Laparoscopy; Laparotomy

DOI：

10.7507/1007-9424.20150075

Video：

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Objective To explore the diagnostic and therapeutic significance of laparoscopic surgery for abdominal trauma patients. Methods Clinical data of 65 patients with abdominal trauma who treated in Affiliated Laigang Hospital of Taishan Medical College from January 2010 to December 2014 were collected retrospectively, all patients were diagnosed by laparoscopic exploration, and therapies were depended on the results of laparoscopic exploration. Results Of the 65 patients, 60 patients were definitely diagnosed through laparoscopic exploration, but 5 patients transferred to laparotomy because of clear diagnosis was not achieved under laparoscopy. Of the 60 patients who were diagnosed clearly by laparoscopy, 23 patients didn't received any intervention because of no obvious injury observed, 27 patients received laparoscopic surgery (3 patients were assisted with hands), and 10 patients transferred to open operation because of peritoneal contamination. Incision infection occurred in 1 patient after operation, 1 patient suffered from subphrenic abscess, and other 63 patients didn't suffered from any complication. All of the patients were discharged successfully. All of the 65 patients were followed up for 2-48 months with the median time of 10 months. Severe complications did not occurred and no patient needed re-operation within the period of follow-up period. Conclusions Laparoscopy is feasible, safe, and effective for the evaluation and treatment of abdominal trauma patients with stable hemodynamics, and it also has a higher diagnostic rate. Laparoscopy can also reduce the negative exploratory laparotomy for the abdominal trauma patients.

Citation： ZHOUZhi-gang, QIZhen-cai, LIHeng-ping, CHENGuo-ting. Clinical Significance of Laparoscopy in Abdominal Trauma: Report of 65 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(3): 278-280. doi: 10.7507/1007-9424.20150075 Copy

1.	Quinn AC, Sinert R. What is the utility of the Focused Assessment with Sonography in Trauma (FAST) exam in penetrating torso trauma?. Injury, 2011, 42(5):482-487.
2.	Soto JA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology, 2012, 265(3):678-693.
3.	O'malley E, Boyle E, O'callaghan A, et al. Role of laparoscopy in penetrating abdominal trauma:a systematic review. World J Surg, 2013, 37(1):113-122.
4.	Kaban GK, Novitsky YW, Perugini RA, et al. Use of laparoscopy in evaluation and treatment of penetrating and blunt abdominal injuries. Surg Innov, 2008, 15(1):26-31.
5.	Mehta N, Babu S, Venugopal K. An experience with blunt abdominal trauma:evaluation, management and outcome. Clin Pract, 2014, 4(2):599.
6.	贺长林, 杨康, 李鸿, 等. 腹腔镜下直肠癌根治术的临床应用. 中国普外基础与临床杂志, 2012, 19(1): 107-108.
7.	郑民华, 马君俊. 腹腔镜外科在争议中发展. 中国普外基础与临床杂志, 2007, 14(5): 503-505.
8.	黄石川, 游志坚, 梁子君, 等. 腹腔镜结直肠肿瘤手术18例报道. 中国普外基础与临床杂志, 2008, 15(10): 722-725.
9.	陈训如. 腹腔镜在闭合性腹部外伤中的应用. 临床外科杂志, 2000, 8(3):141-142.
10.	Berci G, Sackier JM, Paz-Partlow M. Emergency laparoscopy. Am J Surg, 1991, 161(3):332-335.
11.	Goettler CE, Bard MR, Toschlog EA. Laparoscopy in trauma. Curr Surg, 2004, 61(6):554-559.
12.	胡斌, 邓剑, 赵叶平, 等. 腹腔镜技术在急腹症诊治中的应用体会. 中国普外基础与临床杂志, 2013, 20(1):85-87.
13.	Kawahara NT, Alster C, Fujimura I, et al. Standard examination system for laparoscopy in penetrating abdominal trauma. J Trauma, 2009, 67(3):589-595.
14.	Shan CX, Ni C, Qiu M, et al. Is laparoscopy equal to laparotomy in detecting and treating small bowel injuries in a porcine model?. World J Gastroenterol, 2012, 18(46):6850-6855.
15.	Simon RJ, Rabin J, Kuhls D. Impact of increased use of laparoscopy on negative laparotomy rates after penetrating trauma. J Trauma, 2002, 53(2):297-302.
16.	Johnson JJ, Garwe T, Raines AR, et al. The use of laparoscopy in the diagnosis and treatment of blunt and penetrating abdominal injuries:10-year experience at a level 1 trauma center. Am J Surg, 2013, 205(3):317-320.

1. Quinn AC, Sinert R. What is the utility of the Focused Assessment with Sonography in Trauma (FAST) exam in penetrating torso trauma?. Injury, 2011, 42(5):482-487.
2. Soto JA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology, 2012, 265(3):678-693.
3. O'malley E, Boyle E, O'callaghan A, et al. Role of laparoscopy in penetrating abdominal trauma:a systematic review. World J Surg, 2013, 37(1):113-122.
4. Kaban GK, Novitsky YW, Perugini RA, et al. Use of laparoscopy in evaluation and treatment of penetrating and blunt abdominal injuries. Surg Innov, 2008, 15(1):26-31.
5. Mehta N, Babu S, Venugopal K. An experience with blunt abdominal trauma:evaluation, management and outcome. Clin Pract, 2014, 4(2):599.
6. 贺长林, 杨康, 李鸿, 等. 腹腔镜下直肠癌根治术的临床应用. 中国普外基础与临床杂志, 2012, 19(1): 107-108.
7. 郑民华, 马君俊. 腹腔镜外科在争议中发展. 中国普外基础与临床杂志, 2007, 14(5): 503-505.
8. 黄石川, 游志坚, 梁子君, 等. 腹腔镜结直肠肿瘤手术18例报道. 中国普外基础与临床杂志, 2008, 15(10): 722-725.
9. 陈训如. 腹腔镜在闭合性腹部外伤中的应用. 临床外科杂志, 2000, 8(3):141-142.
10. Berci G, Sackier JM, Paz-Partlow M. Emergency laparoscopy. Am J Surg, 1991, 161(3):332-335.
11. Goettler CE, Bard MR, Toschlog EA. Laparoscopy in trauma. Curr Surg, 2004, 61(6):554-559.
12. 胡斌, 邓剑, 赵叶平, 等. 腹腔镜技术在急腹症诊治中的应用体会. 中国普外基础与临床杂志, 2013, 20(1):85-87.
13. Kawahara NT, Alster C, Fujimura I, et al. Standard examination system for laparoscopy in penetrating abdominal trauma. J Trauma, 2009, 67(3):589-595.
14. Shan CX, Ni C, Qiu M, et al. Is laparoscopy equal to laparotomy in detecting and treating small bowel injuries in a porcine model?. World J Gastroenterol, 2012, 18(46):6850-6855.
15. Simon RJ, Rabin J, Kuhls D. Impact of increased use of laparoscopy on negative laparotomy rates after penetrating trauma. J Trauma, 2002, 53(2):297-302.
16. Johnson JJ, Garwe T, Raines AR, et al. The use of laparoscopy in the diagnosis and treatment of blunt and penetrating abdominal injuries:10-year experience at a level 1 trauma center. Am J Surg, 2013, 205(3):317-320.

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Clinical Significance of Laparoscopy in Abdominal Trauma: Report of 65 Cases

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