Barzana Daniel C, Kotwall Cyrus A, Clancy Thomas V, Hope William W
South East Area Health Education Center, Department of Surgery, New Hanover Regional Medical Center, Wilmington, North Carolina, USA.
JSLS. 2011 Apr-Jun;15(2):179-81. doi: 10.4293/108680811X13071180406358.
Enthusiasm for the use of laparoscopy in trauma has not rivaled that for general surgery. The purpose of this study was to evaluate our experience with laparoscopy at a level II trauma center.
A retrospective review of all trauma patients undergoing diagnostic or therapeutic laparoscopy was performed from January 2004 to July 2010.
Laparoscopy was performed in 16 patients during the study period. The average age was 35 years. Injuries included left diaphragm in 4 patients, mesenteric injury in 2, and vaginal laceration, liver laceration, small bowel injury, renal laceration, urethral/pelvic, and colon injury in 1 patient each. Diagnostic laparoscopy was performed in 11 patients (69%) with 3 patients requiring conversion to an open procedure. Successful therapeutic laparoscopy was performed in 5 patients for repair of isolated diaphragm injuries (2), a small bowel injury, a colon injury, and placement of a suprapubic bladder catheter. Average length of stay was 5.6 days (range, 0 to 23), and 75% of patients were discharged home. Morbidity rate was 13% with no mortalities or missed injuries.
Laparoscopy is a seldom-used modality at our trauma center; however, it may play a role in a select subset of patients.
在创伤治疗中，腹腔镜的应用热度不及普通外科手术。本研究旨在评估我们在二级创伤中心开展腹腔镜手术的经验。
对2004年1月至2010年7月期间所有接受诊断性或治疗性腹腔镜手术的创伤患者进行回顾性研究。
在研究期间，对16例患者实施了腹腔镜手术。患者平均年龄为35岁。损伤情况包括4例左侧膈肌损伤、2例肠系膜损伤，以及各1例阴道撕裂伤、肝裂伤、小肠损伤、肾裂伤、尿道/骨盆损伤和结肠损伤。11例患者（69%）接受了诊断性腹腔镜检查，其中3例需要转为开腹手术。5例患者成功接受了治疗性腹腔镜手术，分别用于修复孤立性膈肌损伤（2例）、1例小肠损伤、1例结肠损伤以及放置耻骨上膀胱导管。平均住院时间为5.6天（范围0至23天），75%的患者出院回家。发病率为13%，无死亡病例或漏诊损伤。
腹腔镜在我们的创伤中心是一种较少使用的方式；然而，它可能在特定的患者亚组中发挥作用。
