Role of laparoscopy in blunt abdominal trauma: a comparative prospective cohort study between laparoscopy and laparotomy in patients with blunt abdominal trauma

Abstract

Background Trauma is considered to be a leading cause of death in young adults. Blunt mechanisms account for ∼95% of injuries. Generally, laparotomy is considered to be the standard procedure used in the trauma cases. Recently, laparoscopic techniques have been increasingly introduced as an alternative to open surgery in trauma cases. Objective In our study, we assessed the efficacy of laparoscopy in managing patients with blunt abdominal trauma to avoid unnecessary laparotomies. Patients and methods An observational prospective cohort study was conducted on all isolated blunt abdominal trauma cases at Ain Shams University Surgery Hospital from 1/3/2019 to 1/9/2019. The total sample size was 50 patients, comprising 25 patients who underwent laparoscopy and another 25 who underwent laparotomy. Results Laparoscopy decreased the operative time in comparison with laparotomy. The mean operative time for patients who underwent laparoscopy was 123.28 min, whereas in patients who underwent laparotomy was 150.48 min. Laparoscopy is associated with decreased postoperative ICU stay (1–3 days) in comparison with laparotomy (2–5 days) and decreased total hospital stay. The rate of complications after laparoscopy is much less than after laparotomy, where two patients had respiratory tract infections and no mortality after laparoscopy, whereas six patients had respiratory tract infections, six patients had wound infection, one patient had deep venous thrombosis, and two patients died after laparotomy. Conclusion Laparoscopy is found to be a good alternative to laparotomy, as it is considered to be a reliable and safe method in hemodynamically stable patients with blunt abdominal trauma. It can be used to reduce the rate of laparotomy with lower morbidity and mortality rates.