THE COMPARISON OF THE RESULTS OF LAPAROSCOPIC AND OPEN SURGICAL TREATMENT OF BLUNT ABDOMINAL INJURIES

A. M. Khadjibaev*, K. S. Elmurodov and B. I. Shukurov

ABSTRACT

Aim: The comparative analysis of the results of laparoscopic and traditional surgical treatment of patients with blunt abdominal trauma (BAT). Patients: The study included 160 patients with BAT with stable hemodynamics (BP system ≥ 90 mm Hg), operated in the Republican Research Center of Emergency Medicine (RRCEM) in the period from 2010 to 2019. The control group consisted of 109 (68.1%) patients who underwent primary wide laparotomy without the use of laparoscopy, the main group included 51 (31.9%) patients whose surgical intervention was started with diagnostic laparoscopy. The mean age of the patients was 33.3±11.4 years. There were 133 (83.1%) men and 27 (16.9%) women. Results: The average duration of laparoscopic procedures for BAT in patients with stable hemodynamics is 57.0±40.8 minutes. Laparoscopy followed by conversion practically does not increase the average duration of the intervention compared to primary wide laparotomy (108.1±28.6 versus 103.0±48.7 min, p=0.657). Laparoscopy helps to reduce the duration of stay in the DRiTh from 2.8±1.1 to 1.8±1.0 days (p<0.001), inpatient treatment from 8.7±3.4 to 5.3±2.9 days (p<0.05), a noticeable decrease in the frequency of postoperative complications from 11.9 to 3.1% (p=0.144). Conclusion: In 62.8% of patients with BAT, injuries are detected intraoperatively, which can potentially be eliminated laparoscopically without any special technical difficulties using routinely used endosurgical instruments, which justifies the expediency of expanding the indications for laparoscopy in abdominal injuries.

Keywords: Blunt abdominal trauma, Diagnosis, Surgical treatment, Laparoscopy, Laparotomy.