Laparoscopic exploration versus conservative treatment in stable blunt abdominal trauma patients

Abstract

Background: Laparoscopy is now a standard procedure in general surgery, and as technique and equipment advance, more complicated procedures are being carried out using this minimally invasive approach. With less patient morbidity, postoperative complications, and recovery time than open procedures, laparoscopic surgery aims to offer equal or better visualisation. Numerous laparoscopic procedures, such as cholecystectomy, gastroesophageal reflux procedures, and diagnostic laparoscopy, have demonstrably achieved this goal. Despite the advantages of laparoscopy in the trauma population, its complexity and potential hemodynamic instability due to intra-abdominal injury typically prevent its use. This cutting-edge technology may help carefully chosen trauma patients. According to estimates, 10% of all deaths worldwide were due to trauma. Methods: This prospective study included 29 patients with history of blunt abdominal trauma and vitally stable following initial resuscitation admitted to Casualty and Emergency Unit, ainshams university hospitals and Elzhor Hospital port said, during the period from June 2022 to December 2022. Results: The patients in study were 21 males (82 % of total) 10 males in (LE) representing approximately 77 % and 11 males in conservative group representing approximately (87 %), and 8 females (18 % of total) 2 females in (LE) and 6 in conservative group. As Regarding the hospital stay, in this study, the patients managed by (LE) had shorter hospital stay in relation to those managed conservatively, as the patients results revealed that the overall hospital stay for (LE) was significantly shorter, with an average of 5.69 ± 1.887 days. In this study, the group that benefit the most from shortening the hospital stay was the patients with haemoperitonium with no definite injuries, followed by patients with splenic injuries, while differences in hospital stay in patients with hepatic injuries were not significant. All patients had access to follow-up information for three months after discharge. There were no infective or late hemorrhagic complications observed. Conclusion: Laparoscopic exploration was found to be most beneficial in patients with blunt abdominal trauma who had a CT scan that revealed haemoperitonium but no organ injuries., and to less extent in cases with splenic injuries, while there was no significant data favoring (LE) on conservative treatment in patients with hepatic injuries.