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Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis

BACKGROUND: There is still no consensus regarding the role of laparoscopy in trauma cases. The purpose of this paper is to assess the value of diagnostic and therapeutic laparoscopy for patients with blunt or penetrating abdominal trauma by performing a systematic review and meta-analysis. METHODS:...

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Autores principales: Wang, Jianjun, Cheng, Liangwang, Liu, Jing, Zhang, Binyin, Wang, Weijun, Zhu, Wenxin, Guo, Yan, Bao, Chuanfei, Hu, Yunli, Qi, Shanxin, Wang, Kai, Zhao, Shuguang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957831/
https://www.ncbi.nlm.nih.gov/pubmed/35350141
http://dx.doi.org/10.3389/fsurg.2022.817134
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author Wang, Jianjun
Cheng, Liangwang
Liu, Jing
Zhang, Binyin
Wang, Weijun
Zhu, Wenxin
Guo, Yan
Bao, Chuanfei
Hu, Yunli
Qi, Shanxin
Wang, Kai
Zhao, Shuguang
author_facet Wang, Jianjun
Cheng, Liangwang
Liu, Jing
Zhang, Binyin
Wang, Weijun
Zhu, Wenxin
Guo, Yan
Bao, Chuanfei
Hu, Yunli
Qi, Shanxin
Wang, Kai
Zhao, Shuguang
author_sort Wang, Jianjun
collection PubMed
description BACKGROUND: There is still no consensus regarding the role of laparoscopy in trauma cases. The purpose of this paper is to assess the value of diagnostic and therapeutic laparoscopy for patients with blunt or penetrating abdominal trauma by performing a systematic review and meta-analysis. METHODS: PubMed, Embase, and the Cochrane library were systemically searched for the randomized controlled trials (RCTs) and non-RCT comparative studies on effectiveness and safety of laparoscopy vs. laparotomy for the two authors independently performed the search, data extraction, and quality assessment. RESULTS: A total of 5,517 patients were enrolled in 23 eligible studies that were published in English. Meta-analysis results suggest that there is no significant difference in the incidence of missed injury and mortality between abdominal trauma patients receiving laparoscopy and those receiving laparotomy. Concerning postoperative complications, compared with patients in the open surgery group, those in the laparoscopy group are at a similar risk of intra-abdominal abscesses, thromboembolism, and ileus, while there is a decreased incidence of wound infection and pneumonia. Besides, patients in the laparoscopy group experience shorter hospitalization times and procedure times. For most outcomes, the sensitivity analysis yielded similar results to the primary analysis. CONCLUSION: Laparoscopic surgery is a practical alternative to laparotomy for appropriate patients. The decision to perform laparoscopy should be based on the experience of the surgeon and the resources available.
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spelling pubmed-89578312022-03-28 Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis Wang, Jianjun Cheng, Liangwang Liu, Jing Zhang, Binyin Wang, Weijun Zhu, Wenxin Guo, Yan Bao, Chuanfei Hu, Yunli Qi, Shanxin Wang, Kai Zhao, Shuguang Front Surg Surgery BACKGROUND: There is still no consensus regarding the role of laparoscopy in trauma cases. The purpose of this paper is to assess the value of diagnostic and therapeutic laparoscopy for patients with blunt or penetrating abdominal trauma by performing a systematic review and meta-analysis. METHODS: PubMed, Embase, and the Cochrane library were systemically searched for the randomized controlled trials (RCTs) and non-RCT comparative studies on effectiveness and safety of laparoscopy vs. laparotomy for the two authors independently performed the search, data extraction, and quality assessment. RESULTS: A total of 5,517 patients were enrolled in 23 eligible studies that were published in English. Meta-analysis results suggest that there is no significant difference in the incidence of missed injury and mortality between abdominal trauma patients receiving laparoscopy and those receiving laparotomy. Concerning postoperative complications, compared with patients in the open surgery group, those in the laparoscopy group are at a similar risk of intra-abdominal abscesses, thromboembolism, and ileus, while there is a decreased incidence of wound infection and pneumonia. Besides, patients in the laparoscopy group experience shorter hospitalization times and procedure times. For most outcomes, the sensitivity analysis yielded similar results to the primary analysis. CONCLUSION: Laparoscopic surgery is a practical alternative to laparotomy for appropriate patients. The decision to perform laparoscopy should be based on the experience of the surgeon and the resources available. Frontiers Media S.A. 2022-03-08 /pmc/articles/PMC8957831/ /pubmed/35350141 http://dx.doi.org/10.3389/fsurg.2022.817134 Text en Copyright © 2022 Wang, Cheng, Liu, Zhang, Wang, Zhu, Guo, Bao, Hu, Qi, Wang and Zhao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Wang, Jianjun
Cheng, Liangwang
Liu, Jing
Zhang, Binyin
Wang, Weijun
Zhu, Wenxin
Guo, Yan
Bao, Chuanfei
Hu, Yunli
Qi, Shanxin
Wang, Kai
Zhao, Shuguang
Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis
title Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis
title_full Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis
title_fullStr Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis
title_full_unstemmed Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis
title_short Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis
title_sort laparoscopy vs. laparotomy for the management of abdominal trauma: a systematic review and meta-analysis
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957831/
https://www.ncbi.nlm.nih.gov/pubmed/35350141
http://dx.doi.org/10.3389/fsurg.2022.817134
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