Alyami Rifan, Alotaibi Ahad E, Almohayya Leen, Jawad Ajyad Al, Almukhayzim Raghad, Alhoumedan Abeer, Aldusari Rakan S
Department of General Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
College of Medicine, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
BMC Surg. 2025 Jan 6;25(1):8. doi: 10.1186/s12893-024-02744-1.
Trauma is a significant health concern globally and is one of the leading causes of illness and death. The laparoscopic approach has gained popularity in trauma care since its inception, becoming increasingly favored for both diagnostic and therapeutic purposes. This study aims to reduce unnecessary laparotomies and assess the effectiveness of laparoscopy in managing patients with blunt abdominal trauma.
The study is a descriptive retrospective study using the medical records of patients with blunt abdominal trauma who were managed with laparoscopy in the Department of General Surgery, King Abdulaziz Medical City in Riyadh. The study period was from 2019 to 2023 and included patients > 18 years with abdominal blunt injury, hemodynamically stable patients, and responding to resuscitation. The relationship between laparoscopic procedures according to the patient's demographic and characteristics was conducted using the Fischer Exact test and independent sample t-test. Values were considered significant with a p-value of less than 0.05.
In this study, 74 patients were included, with 94.6% being males. The average age of the patients was 36.3 years (standard deviation of 12.5 years). The primary cause of trauma was motor vehicle accidents (MVAs), accounting for 91.9% of cases. The most common surgical approach used was laparotomy, performed in 71.6% of patients. Additionally, CT scans revealed that solid organ injuries were the most frequently detected type of injury, occurring in 41.9% of cases. Following surgery, 78.4% of the patients underwent therapeutic procedures after laparotomy, while 37.8% received therapeutic interventions post-laparoscopy.
While laparoscopic techniques have been used for decades in abdominal surgeries, a consensus on their effectiveness and accuracy in diagnosing blunt abdominal injuries in trauma settings is still lacking. Laparoscopy is considered safe and feasible for hemodynamically stable patients, and our findings suggest it is equally effective in trauma cases for those who can tolerate the procedure. We recommend conducting further studies with larger sample sizes and more variables to provide sufficient data to accurately assess the efficacy and safety of laparoscopy in trauma situations.
创伤是全球范围内一个重大的健康问题，是疾病和死亡的主要原因之一。自腹腔镜手术问世以来，它在创伤治疗中越来越受欢迎，在诊断和治疗方面都越来越受到青睐。本研究旨在减少不必要的剖腹手术，并评估腹腔镜手术在处理钝性腹部创伤患者中的有效性。
本研究是一项描述性回顾性研究，使用了利雅得阿卜杜勒阿齐兹国王医疗城综合外科接受腹腔镜手术治疗的钝性腹部创伤患者的病历。研究期间为2019年至2023年，纳入年龄大于18岁、腹部钝性损伤、血流动力学稳定且对复苏有反应的患者。根据患者的人口统计学和特征，使用Fisher精确检验和独立样本t检验来分析腹腔镜手术之间的关系。p值小于0.05时认为差异具有统计学意义。
本研究共纳入74例患者，其中男性占94.6%。患者的平均年龄为36.3岁（标准差为12.5岁）。创伤的主要原因是机动车事故（MVA），占病例的91.9%。最常用的手术方式是剖腹手术，71.6%的患者接受了该手术。此外，CT扫描显示实体器官损伤是最常检测到的损伤类型，占病例的41.9%。手术后，78.4%的患者在剖腹手术后接受了治疗性手术，而37.8%的患者在腹腔镜检查后接受了治疗性干预。
虽然腹腔镜技术在腹部手术中已经使用了几十年，但在创伤环境中诊断钝性腹部损伤的有效性和准确性方面仍缺乏共识。对于血流动力学稳定的患者，腹腔镜手术被认为是安全可行的，我们的研究结果表明，对于能够耐受该手术的患者，腹腔镜手术在创伤病例中同样有效。我们建议进行更大样本量和更多变量的进一步研究，以提供足够的数据来准确评估腹腔镜手术在创伤情况下的疗效和安全性。
