Laparoscopic management of retroperitoneal injuries from penetrating abdominal trauma in haemodynamically stable patients

Journal of Minimal Access Surgery
Modise Z KotoC Aldous

Abstract

Laparoscopy is increasingly utilised in the trauma setting. However, its safety and reliability in evaluating and managing retroperitoneal injuries are not known. The aim of this study was to analyse our experience with laparoscopic management of retroperitoneal injuries due to penetrating abdominal trauma (PAT) and to investigate its feasibility, safety and accuracy in haemodynamically stable patients. Over a 4-year period, patients approached laparoscopically with retroperitoneal injuries were analysed. Mechanism, location and severity of injuries were recorded. Surgical procedures, conversion rate and reasons for conversion and outcomes were described. Of the 284 patients with PAT, 56 patients had involvement of retroperitoneum. Stab wounds accounted 62.5% of patients. The mean Injury Severity Score was 7.4 (4-20). Among retroperitoneal injuries, the colon (27%) was the most commonly involved hollow viscera followed by duodenum (5%). The kidney (5%) and the pancreas (4%) were the injured solid organs. The conversion rate was 19.6% and was mainly due to active bleeding (73%). Significantly more patients with gunshot wound were converted to laparotomy (38% vs. 9%). Therapeutic laparoscopy was performed in 36% of patients. Ther...Continue Reading

References

Jun 1, 1993·The Journal of Trauma·R R IvaturyW M Stahl
Sep 11, 2007·Emergency Medicine Clinics of North America·Jennifer L Isenhour, John Marx
Jul 30, 2009·Annals of Surgery·Pierre A ClavienMasatoshi Makuuchi
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Dec 3, 2014·World Journal of Surgery·Selman UranuesRudolph Schrittwieser
Aug 12, 2015·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Modise Z KotoSooraj R Motilall
Aug 13, 2015·Annals of the Royal College of Surgeons of England·V Y KongD L Clarke
Nov 20, 2016·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Modise Z KotoColleen Aldous
Jun 21, 2017·International Journal of Surgery·Oleh Yevhenovych MatsevychColleen Aldous

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Citations

Apr 17, 2021·International Journal of Surgery Case Reports·Hadeel Ayman HelmiIbrahim Tawfiq Albabtain

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