Trauma laparoscopy from 1925 to 2017: Publication history and study demographics of an evolving modality

Coleman, Lauren; Gilna, Gareth P.; Portenier, Dana; Auyang, Edward D.; Khan, Uzer; Grabo, Daniel; Wilson, Alison; Szoka, Nova

doi:10.1097/ta.0000000000001780

Cited by 17 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More extensive/ severe injuries serve as indications to perform laparotomy as initial therapy or if encountered intraoperative, conversion to LtL. [30][31][32][33] The decision to convert an abdominal procedure from a laparoscopic to open laparotomy approach is traditionally made on the basis of poor injury visibility, hemodynamic instability, injury severity/complexity, copious bleeding, or technical challenges. 22,34,35 Those who underwent laparotomy and LtL did not have significantly reduced aOR of mortality compared to patients who underwent laparoscopy when controlling for potential confounders.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Versus Laparotomy Surgical Interventions for Trauma Patients With Single Upper Left Quadrant Penetrating Injuries: Analysis of the American College of Surgeons Trauma Quality Improvement Program Dataset

Elkbuli

Newsome

Fanfan

et al. 2022

The American Surgeon

View full text Add to dashboard Cite

Background We aim to identify patient cohorts where laparoscopy can be safely utilized with comparable or better outcomes to laparotomy among patients with single penetrating LUQ injuries with a hypothesis that compared to laparotomy, laparoscopy may be associated with equal or improved outcomes of low injury severity patients. Methods Retrospective review of the ACS-TQP-Participant Use File 2016-2019 dataset. Patients with single LUQ penetrating injuries were included. Primary outcome was risk-adjusted in-hospital mortality. Secondary outcomes included: risk-adjusted complication rates, hospital length-of-stay (H-LOS), and ICU-LOS. Descriptive statistics and multivariable regression with reliability adjustments to account for variations in practice were performed. Results Of 4149 patients analyzed, 3571 (86.1%) underwent laparotomy, 489 (11.8%) underwent laparoscopy, and 89 (2.1%) underwent laparoscopy-to-laparotomy conversion. Adjusted mortality rates were not significantly different among all study cohorts (P > .05). Compared to laparoscopy, adjusted odds of complications were 4.3-fold higher for all patients who underwent laparotomy and 4-fold higher for laparoscopy-to-laparotomy (LtL) patients (P < .05). Diaphragmatic injuries were associated with significantly increased odds of undergoing LtL, whereas sustaining a colonic injury, gastric injury, hepatic injury, or requiring PRBC transfusions were associated with significantly increased odds of undergoing laparotomy (P < .05). H-LOS (days) was significantly longer for patients who underwent laparotomy compared to laparoscopy (3.9 ± 4.0 vs. 10.8 ± 13.4, P < .0001). Conclusions Laparoscopy may be considered a viable alternative to laparotomy for hemodynamically stable adult patients with single penetrating LUQ injuries of low injury burden validating our hypothesis. Laparoscopy may be less safe for patients with associated diaphragmatic, colonic, or hepatic injuries.

show abstract

Section: Discussionmentioning

confidence: 99%

Laparoscopic Versus Laparotomy Surgical Interventions for Trauma Patients With Single Upper Left Quadrant Penetrating Injuries: Analysis of the American College of Surgeons Trauma Quality Improvement Program Dataset

Elkbuli

Newsome

Fanfan

et al. 2022

The American Surgeon

View full text Add to dashboard Cite

show abstract

“…Each decade has seen an increased utilization of laparoscopy in trauma as modern surgical graduates become more comfortable with the approach. 48 Additionally, laparotomy is not benign and, in the setting of trauma, can be nontherapeutic. Nontherapeutic laparotomy is associated with increased mortality (odds ratio [OR] 4.5), higher rate of complications (OR, 2.2), and longer hospital stay (OR, 2.7).…”

Section: Small Bowelmentioning

confidence: 99%

Blunt and Penetrating Injury to the Bowel: A Review

Skelhorne-Gross,

Kenny

2023

Clin Colon Rectal Surg

View full text Add to dashboard Cite

Traumatic injuries to the small and large bowel are common and can be highly morbid. Identifying these injuries, especially in stable patients who suffer blunt trauma, can be challenging. It is critical that traumatic bowel injuries are diagnosed in a timely fashion as delays in diagnosis and treatment are associated with worse outcomes. The literature outlining the management of traumatic bowel injuries is mostly comprised of retrospective data and case reports/series. We have compiled the existing literature and relevant guidelines into a single resource for providers who care for traumatically injured patients.

show abstract

“…Laparoscopic surgery is gaining importance in the management of abdominal trauma. Many studies have explored this in recent years [ 4 ], and shown the advantages of this approach in hemodynamically stable patients. In fact, while trauma patients can benefit from the same advantages of laparoscopy for elective surgery (less abdominal pain, less wound infections, and faster recovery), the risks of both diagnostic and therapeutic laparoscopic surgery for trauma, such as missed injuries or the need for conversion, are limited if minimally invasive surgery is performed by experienced surgeons [ 54 , 55 ].…”

Section: Current Indications For Laparoscopic Splenectomy For Splenic Traumatic Injuriesmentioning

confidence: 99%

“…However, the continued evolution of materials and technologies, together with the improved laparoscopic skills of surgeons, has led to laparoscopic surgery being used more frequently in emergency situations. In particular, the use of laparoscopy both with diagnostic and therapeutic intent in hemodynamically stable trauma patient has increased in recent years [ 4 ]. In the early 1990s, some authors reported performing laparoscopic surgery for splenic trauma.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery for splenic injuries in the era of non-operative management: current status and future perspectives

et al. 2020

View full text Add to dashboard Cite

The spleen is one of the organs most commonly injured by blunt abdominal trauma. It plays an important role in immune response to infections, especially those sustained by encapsulated bacteria. Nonoperative management (NOM), comprising clinical and radiological observation with or without angioembolization, is the treatment of choice for traumatic splenic injury in patients who are hemodynamically stable. However, this strategy carries a risk of failure, especially for high-grade injuries. No clear predictors of failure have been identified, but minimally invasive surgery for splenic injury is gaining popularity. Laparoscopic surgery has been proposed as an alternative to open surgery for hemodynamically stable patients who require surgery, such as after failed NOM. We reviewed research articles on laparoscopic surgery for hemodynamically stable patients with splenic trauma to explore the current knowledge about this topic. After presenting an overview of the treatments for splenic trauma and the immunological function of the spleen, we try to identify the future indications for laparoscopic surgery in the era of NOM.

show abstract

Trauma laparoscopy from 1925 to 2017: Publication history and study demographics of an evolving modality

Cited by 17 publications

References 15 publications

Laparoscopic Versus Laparotomy Surgical Interventions for Trauma Patients With Single Upper Left Quadrant Penetrating Injuries: Analysis of the American College of Surgeons Trauma Quality Improvement Program Dataset

Laparoscopic Versus Laparotomy Surgical Interventions for Trauma Patients With Single Upper Left Quadrant Penetrating Injuries: Analysis of the American College of Surgeons Trauma Quality Improvement Program Dataset

Blunt and Penetrating Injury to the Bowel: A Review

Laparoscopic surgery for splenic injuries in the era of non-operative management: current status and future perspectives

Contact Info

Product

Resources

About