Laparoscopy versus conventional laparotomy in the management of abdominal trauma: a multi-institutional matched-pair study

Gao, Yunhe; Li, Shaoqing; Xi, Hongqing; Bian, Sainan; Zhang, Kecheng; Cui, Jianxin; Li, Jiyang; Liu, Feide; Liu, Yi; Lu, Yuhan; Wang, Baohua; Qiao, Zhi; Chen, Lin

doi:10.1007/s00464-019-07013-4

Cited by 21 publications

(23 citation statements)

References 27 publications

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“…The literature search initially identified 1, 358 papers, of which 41 studies were eligible for the full-text screening process, and 23 studies (7,8,12,(17)(18)(19)(20)(21)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) were included in the metaanalysis. The PRISMA flow diagram is illustrated in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…The 23 studies encompassed one RCT ( 30 ), two prospective observational studies ( 29 , 35 ) and 20 retrospective observational studies ( 7 , 8 , 12 , 17 – 21 , 27 , 28 , 31 – 34 , 36 – 41 ). Four ( 33 , 34 , 37 , 41 ) of the 20 retrospective observational studies were based on controlled before and after study designs, while the remainder were comparative/parallel studies.…”

Section: Resultsmentioning

confidence: 99%

“…However, since laparotomy is associated with morbidity ranging from 20 to 40% (5)(6)(7), it may be preferable to avoid unnecessary laparotomies. In haemodynamically stable conditions and conducted by experienced surgeons, laparoscopy is an effective and safe in the management of abdominal trauma patients (8). Advances of imaging technology and selective nonoperative management have led to a decrease in non-therapeutic laparotomy for haemodynamically stable patients (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, as a diagnostic or therapeutic tool, laparoscopy involves less pain and results in a shorter hospital stays and faster recovery times than laparotomy. Although the feasibility and benefits of diagnostic and therapeutic laparoscopy in selected haemodynamically stable trauma patients have already been demonstrated, a widely accepted consensus has not yet been reached (8,13). Soon after the laparoscopy procedure was introduced, several systematic reviews (14)(15)(16) summarizing its value for penetrating or blunt abdominal trauma were published.…”

Section: Introductionmentioning

confidence: 99%

“…Soon after the laparoscopy procedure was introduced, several systematic reviews (14)(15)(16) summarizing its value for penetrating or blunt abdominal trauma were published. Subsequently, a series of papers (7,8,12,(17)(18)(19)(20)(21) were published addressing a wide range of possibilities for the application of laparoscopy in abdominal trauma. In this review, we integrated newly published studies with previous evidence to comprehensively compare the effectiveness and safety of laparoscopy with laparotomy on penetrating or blunt abdominal trauma.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis

Wang¹,

Cheng²,

Liu³

et al. 2022

Front. Surg.

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BackgroundThere is still no consensus regarding the role of laparoscopy in trauma cases. The purpose of this paper is to assess the value of diagnostic and therapeutic laparoscopy for patients with blunt or penetrating abdominal trauma by performing a systematic review and meta-analysis.MethodsPubMed, Embase, and the Cochrane library were systemically searched for the randomized controlled trials (RCTs) and non-RCT comparative studies on effectiveness and safety of laparoscopy vs. laparotomy for the two authors independently performed the search, data extraction, and quality assessment.ResultsA total of 5,517 patients were enrolled in 23 eligible studies that were published in English. Meta-analysis results suggest that there is no significant difference in the incidence of missed injury and mortality between abdominal trauma patients receiving laparoscopy and those receiving laparotomy. Concerning postoperative complications, compared with patients in the open surgery group, those in the laparoscopy group are at a similar risk of intra-abdominal abscesses, thromboembolism, and ileus, while there is a decreased incidence of wound infection and pneumonia. Besides, patients in the laparoscopy group experience shorter hospitalization times and procedure times. For most outcomes, the sensitivity analysis yielded similar results to the primary analysis.ConclusionLaparoscopic surgery is a practical alternative to laparotomy for appropriate patients. The decision to perform laparoscopy should be based on the experience of the surgeon and the resources available.

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