The management of penetrating abdominal trauma by diagnostic laparoscopy: A Prospective non-randomized study

INTRODUCTION: Penetrating abdominal trauma (PAT) has been traditionally treated by exploratory laparotomy (EL). The aim of our study was to examine the use of diagnostic laparoscopy (DL) in the management of hemodynamically stable patients with PAT.
MATERIALS and METHODS: A prospective study was performed to compare the outcomes of hemodynamically stable patients with suspected intra-abdominal injuries due to abdominal stab wounds who underwent either EL or DL. Data extracted for analysis included demographic information, operative findings, length of hospital stay, mortality, and postoperative complications.
RESULTS: 52 hemodynamically stable patients were admitted to the trauma service. There were 45 male (86.5 %) and 7 female (13.5 %); average age was 34, 5 years-old (18 – 60). 26 (50 %) patients underwent EL, and 26 (50 %) patients underwent DL. Re-exploration by laparotomy was required in 9 of the 26 cases (34, 6 %). Patients who underwent DL had significantly shorter hospital stay (1,82±0,63 days versus 5,4 ±2,1 days; P<0.05) and shorter operation time (17,9±6,38 versus 68,4±33,2 minutes; P <0.05) than patients who underwent EL.
CONCLUSION: Selective use of DL in the hemodinamically stable patients with PAT effectively decreased the rate of negative laparotomies, minimized morbidity, and decreased hospital stay.
Key words: Diagnostic laparoscopy, penetrating abdominal trauma