Fu Jing-Nan, Zhou Li, Ma Tao
Department of Minimally Invasive Surgery, Characteristics Medical Center of Chinese People Armed Police Force, Tianjin, China.
Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Heliyon. 2023 Oct 5;9(10):e20705. doi: 10.1016/j.heliyon.2023.e20705. eCollection 2023 Oct.
To investigate the effect of laparoscopy on the diagnosis and treatment of closed abdominal injury.
A total of 26 patients with closed abdominal injury admitted to our hospital from January 2016 to January 2019 were searched. All patients were treated by laparoscopy. All patient reports were made with the informed consent of the patients.
All patients were diagnosed clearly during operation. Among them, there were 3 cases of gastric perforation, 2 cases of liver rupture, 13 cases of spleen rupture, 3 cases of small intestine rupture, 1 case of liver round ligament laceration, 2 cases of small mesenteric vascular laceration, 1 case of colon liver mesenteric laceration, and 1 case of retroperitoneal hematoma. Of the 26 patients in this group, 23 (88.5%) completed laparoscopically or laparoscopically assisted; 5 cases (19.3%) only performed laparoscopic exploration without special treatment, and 3 cases (11.5%) switched to laparotomy. The blood loss was 50-2000 ml (mean 500 ml), and the operative time was 60-180min (mean 128min). The length of hospital stay was 3-21 d (mean 9 d). There were no complications or deaths related to laparoscopy in the whole group. Conclusion Laparoscopic technique has the advantages of less trauma, high diagnosis rate and fast recovery. It can also be used for surgical treatment in the diagnosis and treatment of closed abdominal injury, so as to achieve the purpose of comprehensive diagnosis and treatment. The limitations of laparoscopy should also be noted.
探讨腹腔镜检查在闭合性腹部损伤诊治中的作用。
检索2016年1月至2019年1月我院收治的26例闭合性腹部损伤患者。所有患者均采用腹腔镜检查进行治疗。所有患者报告均在患者知情同意下完成。
所有患者在手术中均得到明确诊断。其中胃穿孔3例，肝破裂2例，脾破裂13例，小肠破裂3例，肝圆韧带裂伤1例，小肠系膜血管裂伤2例，结肠肝系膜裂伤1例，腹膜后血肿1例。该组26例患者中，23例（88.5%）完成了腹腔镜或腹腔镜辅助手术；5例（19.3%）仅行腹腔镜探查未作特殊处理，3例（11.5%）中转开腹。出血量为50～2000ml（平均500ml），手术时间为60～180分钟（平均128分钟）。住院时间为3～21天（平均9天）。全组无腹腔镜相关并发症及死亡。结论腹腔镜技术具有创伤小、诊断率高、恢复快等优点，在闭合性腹部损伤的诊治中也可用于手术治疗，以达到综合诊治目的。同时也应注意腹腔镜检查的局限性。
