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Abstract：
Laparoscopy is being increasingly applied as either a diagnostic or therapeutic intervention in the management of abdominal trauma. However, its outcomes in comparison with conventional laparotomy remain unclear, especially in terms of therapeutic management.
This retrospective cohort study included patients from three trauma centers in Beijing, China. Fifty-four patients undergoing laparoscopic interventions for abdominal trauma by experienced laparoscopists were enrolled in the laparoscopy group (LP group). Another 54 patients who underwent laparotomy (LT group) were matched according to the patients\' baseline characteristics, causes of injury, and hemodynamic parameters. Perioperative clinical parameters and short-term survival were compared between these two groups.
The baseline characteristics were comparable between these two groups (LP vs. LT: Age, p = 0.112; Sex, p = 0.820; Injury severity score, p = 0.158; Cause distribution, p = 0.840). The most common cause was traffic accident (36.1%) and the most frequent surgical intervention was bowel repair/resection (34.3%) in our study. The operation time was similar in these two groups (LP vs. LT: 202.2 ± 72.58 vs. 194.11 ± 82.95 min, p = 0.295) while post-operative complication rate was slightly reduced in LP group (7.7% vs. 13.5%) with no statistical significance (p = 0.383). Opioid use was lower in the LP than LT group (11.67 ± 4.08 vs. 26.0 ± 13.42 morphine equivalents (MEQ), p = 0.034). The hospital stay was significantly shorter in the LP group (13.48 ± 10.9 vs. 18.64 ± 14.73 days, p = 0.021). One patient in the LT group died of an intra-abdominal abscess and multiple organ dysfunction syndrome 19 days postoperatively, while all patients in the LP group recovered and were discharged.
Laparoscopy is feasible and safe in treating abdominal trauma patients in hemodynamically stable conditions performed by experienced surgeons. Laparoscopy might have the advantages of reduced pain and quicker recovery with similarly favorable clinical outcomes.
This retrospective cohort study included patients from three trauma centers in Beijing, China. Fifty-four patients undergoing laparoscopic interventions for abdominal trauma by experienced laparoscopists were enrolled in the laparoscopy group (LP group). Another 54 patients who underwent laparotomy (LT group) were matched according to the patients\' baseline characteristics, causes of injury, and hemodynamic parameters. Perioperative clinical parameters and short-term survival were compared between these two groups.
The baseline characteristics were comparable between these two groups (LP vs. LT: Age, p = 0.112; Sex, p = 0.820; Injury severity score, p = 0.158; Cause distribution, p = 0.840). The most common cause was traffic accident (36.1%) and the most frequent surgical intervention was bowel repair/resection (34.3%) in our study. The operation time was similar in these two groups (LP vs. LT: 202.2 ± 72.58 vs. 194.11 ± 82.95 min, p = 0.295) while post-operative complication rate was slightly reduced in LP group (7.7% vs. 13.5%) with no statistical significance (p = 0.383). Opioid use was lower in the LP than LT group (11.67 ± 4.08 vs. 26.0 ± 13.42 morphine equivalents (MEQ), p = 0.034). The hospital stay was significantly shorter in the LP group (13.48 ± 10.9 vs. 18.64 ± 14.73 days, p = 0.021). One patient in the LT group died of an intra-abdominal abscess and multiple organ dysfunction syndrome 19 days postoperatively, while all patients in the LP group recovered and were discharged.
Laparoscopy is feasible and safe in treating abdominal trauma patients in hemodynamically stable conditions performed by experienced surgeons. Laparoscopy might have the advantages of reduced pain and quicker recovery with similarly favorable clinical outcomes.
摘要：
腹腔镜检查越来越多地用作腹部创伤的诊断或治疗干预。然而,与传统剖腹手术相比，其结果仍不清楚，特别是在治疗管理方面。
这项回顾性队列研究包括来自北京三个创伤中心的患者，中国。由经验丰富的腹腔镜医师对腹部创伤进行腹腔镜干预的54例患者被纳入腹腔镜组（LP组）。另外54例接受剖腹手术的患者（LT组）根据患者的基线特征进行匹配，伤害的原因,和血液动力学参数。比较两组的围手术期临床参数和短期生存率。
这两组的基线特征相当（LP与LT:年龄,p=0.112；性别，p=0.820；损伤严重程度评分，p=0.158；原因分布，p=0.840）。在我们的研究中，最常见的原因是交通事故（36.1％），最常见的手术干预是肠修复/切除（34.3％）。两组的手术时间相似(LPvs.LT：202.2±72.58vs.194.11±82.95min,p=0.295），而LP组术后并发症发生率略有降低（7.7％vs.13.5%)无统计学意义(p=0.383)。LP组的阿片类药物使用率低于LT组（11.67±4.08vs.26.0±13.42吗啡当量（MEQ），p=0.034)。LP组住院时间明显缩短(13.48±10.9vs.18.64±14.73天,p=0.021)。LT组1例患者术后19天死于腹内脓肿和多器官功能障碍综合征,而LP组所有患者均康复出院。
由经验丰富的外科医生进行的腹腔镜检查在血液动力学稳定的条件下治疗腹部创伤患者是可行且安全的。腹腔镜检查可能具有减轻疼痛和更快恢复的优点，并具有类似的良好临床结果。
这项回顾性队列研究包括来自北京三个创伤中心的患者，中国。由经验丰富的腹腔镜医师对腹部创伤进行腹腔镜干预的54例患者被纳入腹腔镜组（LP组）。另外54例接受剖腹手术的患者（LT组）根据患者的基线特征进行匹配，伤害的原因,和血液动力学参数。比较两组的围手术期临床参数和短期生存率。
这两组的基线特征相当（LP与LT:年龄,p=0.112；性别，p=0.820；损伤严重程度评分，p=0.158；原因分布，p=0.840）。在我们的研究中，最常见的原因是交通事故（36.1％），最常见的手术干预是肠修复/切除（34.3％）。两组的手术时间相似(LPvs.LT：202.2±72.58vs.194.11±82.95min,p=0.295），而LP组术后并发症发生率略有降低（7.7％vs.13.5%)无统计学意义(p=0.383)。LP组的阿片类药物使用率低于LT组（11.67±4.08vs.26.0±13.42吗啡当量（MEQ），p=0.034)。LP组住院时间明显缩短(13.48±10.9vs.18.64±14.73天,p=0.021)。LT组1例患者术后19天死于腹内脓肿和多器官功能障碍综合征,而LP组所有患者均康复出院。
由经验丰富的外科医生进行的腹腔镜检查在血液动力学稳定的条件下治疗腹部创伤患者是可行且安全的。腹腔镜检查可能具有减轻疼痛和更快恢复的优点，并具有类似的良好临床结果。
