Karateke Faruk, Özdoğan Mehmet, Özyazıcı Sefa, Daş Koray, Menekşe Ebru, Gülnerman Yusuf Can, Bali Ilhan, Önel Safa, Gökler Cihan
Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):53-7. doi: 10.5505/tjtes.2013.40799.
Penetrating abdominal trauma (PAT) has been traditionally treated by exploratory laparotomy (EL). The aim of our study was to examine the use of diagnostic laparoscopy (DL) in the management of hemodynamically stable patients with PAT.
A prospective study was performed to compare the outcomes of hemodynamically stable patients with suspected intra-abdominal injuries due to abdominal stab wounds who underwent either EL or DL. Data extracted for analysis included demographic information, operative findings, rates of non-therapeutic laparotomy, operation time, length of hospital stay, mortality, and postoperative complications.
Fifty-two hemodynamically stable patients were admitted to the trauma service. There were 45 male (86.5%) and 7 female (13.5%) patients. The average age was 34.5 years-old (18-60). 26 (50%) patients underwent EL, and 26 (50%) patients underwent DL. Re-exploration by laparotomy was required in 9 of the 26 cases (34.6%). Patients who underwent DL had significantly shorter hospital stays (1.82±0.63 days vs. 5.4±2.1 days, p<0.05) and shorter operation time (17.9±6.38 vs. 68.4±33.2 min, p<0.05) than patients who underwent EL.
Selective use of DL in the hemodinamically stable penetrating trauma patients effectively decreased the rate of negative laparotomies, minimized morbidity, and decreased hospital stay.
穿透性腹部创伤（PAT）传统上采用剖腹探查术（EL）进行治疗。我们研究的目的是探讨诊断性腹腔镜检查（DL）在血流动力学稳定的PAT患者管理中的应用。
进行一项前瞻性研究，比较因腹部刺伤而疑似腹内损伤的血流动力学稳定患者接受EL或DL的结果。提取用于分析的数据包括人口统计学信息、手术发现、非治疗性剖腹术的发生率、手术时间、住院时间、死亡率和术后并发症。
52例血流动力学稳定的患者被收治到创伤科。其中男性45例（86.5%），女性7例（13.5%）。平均年龄为34.5岁（18 - 60岁）。26例（50%）患者接受了EL，26例（50%）患者接受了DL。26例中有9例（34.6%）需要再次进行剖腹探查术。与接受EL的患者相比，接受DL的患者住院时间明显更短（1.82±0.63天对5.4±2.1天，p<0.05），手术时间也更短（17.9±6.38对68.4±33.2分钟，p<0.05）。
在血流动力学稳定的穿透性创伤患者中选择性使用DL可有效降低阴性剖腹术的发生率，将发病率降至最低，并缩短住院时间。
