The results of surgical treatment of patients with open abdominal injury

Abstract

Objective: To study the evolution of approaches to surgical treatment in patients with open abdominal trauma.Material and methods: The results of surgical treatment of 141 patients with open abdominal trauma at the age of 32.6 ± 7.3 years have been studied. In the main group of 73 patients, surgical tactics have been determined according to the results of the Focused Assessment with Sonography for Trauma (FAST) protocol and diagnostic video laparoscopy. In the control group of 68 patients, indications for laparotomy have been presented based on the proven fact of a penetrating wound in the abdominal cavity.Results: In patients with unstable hemodynamics and signs of peritonitis there is no need for additional verification of the damage nature. In these cases, an emergency laparotomy is justified. In debatable cases diagnostic video laparoscopy should be the method of choice for the diagnosis. In 19 (27.9%) patients in the control group with the proven fact of a an abdominal penetrating wound during primary surgical treatment (PST), no injuries were detected during the examination of the abdominal organs and the laparotomy was exploratory.Conclusion: A rational approach to assessment of the injuries severity using the FAST protocol and diagnostic video laparoscopy in patients of the main group made it possible to completely avoid exploratory laparotomy and increase the proportion of minimally invasive interventions to 50–70%. The accuracy of laparoscopic diagnostics was 98%.

Keywords

• open abdominal trauma
• fast protocol
• diagnostic video laparoscopy