SELECTIVE NONOPERATIVE MANAGEMENT OF PENETRATING ABDOMINAL STAB WOUNDS: RETROSPECTIVE COHORT STUDY

Abstract

Introduction: in modern conditions, the number of patients with penetrating abdominal wounds remains high. At present, in urgent surgical practice, the problem of developing a unified algorithm for the diagnosis and treatment of hemodynamically stable patients with penetrating abdominal stab wounds in order to reduce the number of «unnecessary» laparotomies/laparoscopies remains relevant.Aim: improving the effectiveness of management of patients with penetrating stab wounds of the abdomen w, the creation and implementation of the Level I trauma centers of the nonoperative algorithm for this category of patients.Materials and methods: a cohort retrospective study for the period from 2018 to 2021 included hemodynamically stable patients with penetrating stab wounds of the abdomen, who were treated at the N.V. Sklifosovsky, to which various surgical tactics were applied. Over a 3-year period, 96 patients were selected, of which 72.9% were men and 27.1% were women. The mean age was 33.6 ± 6.5 years. 34 (35.4%) patients were treated conservatively, exploratory laparotomy was performed in 22 (22.9%) patients, exploratory laparoscopy was performed in 40 (41.7%) patients. Results: the analysis of the data obtained during the study revealed a significant decrease in the number of intra- and postoperative complications, a decrease in the duration of hospital stay by using selective non operative management in hemodynamically stable patients.Conclusion: a selective conservatism in hemodynamically stable patients are effective and allow avoiding «unnecessary» surgical interventions, reducing the level of disability and mortality.