Diagnostic and therapeutic laparoscopy for stab wounds of the anterior abdomen.
J Laparoendosc Adv Surg Tech A
; 13(5): 309-12, 2003 Oct.
Article
em En
| MEDLINE
| ID: mdl-14617388
ABSTRACT
BACKGROUND:
At present, laparoscopy is used mainly as a diagnostic tool in patients with abdominal stab wounds. PATIENTS ANDMETHODS:
Thirty-two hemodynamically stable patients with isolated stab wounds of the anterior abdomen, thought to be penetrating, were prospectively selected to undergo treatment via a laparoscopic approach. When possible, parenchymal wounds were coagulated or sealed, and wounds to the intestines were sutured or stapled.RESULTS:
The results of laparoscopy were negative in 6 (18.8%) of the cases nonpenetrating wounds in 4 cases and nonsignificant organ injury in 2 cases. A hemoperitoneum was identified in 13 (40.6%) of the cases, and significant organ injuries in 26 (81.3%) of the cases stomach, 2; small bowel, 5; colon, 2; pancreas, 1; vascular injuries, 4; liver, 5; mesentery, 9. Laparoscopy was therapeutic in 20 (62.3%) of the cases. Conversion to open surgery was required in 6 (18.8%) of the cases. No injuries were missed, and no mortality occurred. Postoperative complications developed in 2 (6.2%) of the cases. The mean hospital stay was 4 days, with no late complications.CONCLUSIONS:
Laparoscopy can avoid a number of unnecessary laparotomies and can treat most of the lesions found in hemodynamically stable patients with anterior abdominal stab wounds.
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Base de dados:
MEDLINE
Assunto principal:
Ferimentos Perfurantes
/
Laparoscopia
/
Traumatismos Abdominais
Idioma:
En
Ano de publicação:
2003
Tipo de documento:
Article