The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis
The efficacy and safety of laparoscopy for blunt trauma remain controversial. This systemic review and meta-analysis aimed to evaluate the usefulness of laparoscopy in blunt trauma. The PubMed, EMBASE, and Cochrane databases were searched up to 23 February 2021. Meta-analyses were performed using od...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-04-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/10/9/1853 |
| _version_ | 1797536486209355776 |
|---|---|
| author | Young-Jun Ki Young-Goun Jo Yun-Chul Park Wu-Seong Kang |
| author_facet | Young-Jun Ki Young-Goun Jo Yun-Chul Park Wu-Seong Kang |
| author_sort | Young-Jun Ki |
| collection | DOAJ |
| description | The efficacy and safety of laparoscopy for blunt trauma remain controversial. This systemic review and meta-analysis aimed to evaluate the usefulness of laparoscopy in blunt trauma. The PubMed, EMBASE, and Cochrane databases were searched up to 23 February 2021. Meta-analyses were performed using odds ratios (ORs), standardized mean differences (SMDs), and overall proportions. Overall, 19 studies with a total of 1520 patients were included. All patients were hemodynamically stable. In the laparoscopy group, meta-analysis showed lesser blood loss (SMD −0.28, 95% confidence interval (CI) −0.51 to −0.05, I<sup>2</sup> = 62%) and shorter hospital stay (SMD −0.67, 95% CI −0.90 to −0.43, I<sup>2</sup> = 47%) compared with the laparotomy group. Pooled prevalence of missed injury (0.003 (95% CI 0 to 0.023), I<sup>2</sup> = 0%), nontherapeutic laparotomy (0.004 (95% CI 0.001 to 0.026), I<sup>2</sup> = 0%), and mortality (0.021 (95% CI 0.010 to 0.043), I<sup>2</sup> = 0%) were very low in blunt trauma. In subgroup analysis, recently published studies (2011–present) showed lesser conversion rate (0.115 (95% CI 0.067 to 0.190) vs. 0.391 (95% CI 0.247 to 0.556), test for subgroup difference: <i>p</i> < 0.01). This meta-analysis suggests that laparoscopy is a safe and feasible option in hemodynamic stable patients with blunt abdominal trauma. |
| first_indexed | 2024-03-10T12:01:23Z |
| format | Article |
| id | doaj.art-f12cd9f037284f20b1308dba691766ac |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:01:23Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f12cd9f037284f20b1308dba691766ac2023-11-21T16:58:23ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01109185310.3390/jcm10091853The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-AnalysisYoung-Jun Ki0Young-Goun Jo1Yun-Chul Park2Wu-Seong Kang3Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, KoreaDivision of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Chonnam National University, Gwangju 61469, KoreaDivision of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Chonnam National University, Gwangju 61469, KoreaDepartment of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju 63127, KoreaThe efficacy and safety of laparoscopy for blunt trauma remain controversial. This systemic review and meta-analysis aimed to evaluate the usefulness of laparoscopy in blunt trauma. The PubMed, EMBASE, and Cochrane databases were searched up to 23 February 2021. Meta-analyses were performed using odds ratios (ORs), standardized mean differences (SMDs), and overall proportions. Overall, 19 studies with a total of 1520 patients were included. All patients were hemodynamically stable. In the laparoscopy group, meta-analysis showed lesser blood loss (SMD −0.28, 95% confidence interval (CI) −0.51 to −0.05, I<sup>2</sup> = 62%) and shorter hospital stay (SMD −0.67, 95% CI −0.90 to −0.43, I<sup>2</sup> = 47%) compared with the laparotomy group. Pooled prevalence of missed injury (0.003 (95% CI 0 to 0.023), I<sup>2</sup> = 0%), nontherapeutic laparotomy (0.004 (95% CI 0.001 to 0.026), I<sup>2</sup> = 0%), and mortality (0.021 (95% CI 0.010 to 0.043), I<sup>2</sup> = 0%) were very low in blunt trauma. In subgroup analysis, recently published studies (2011–present) showed lesser conversion rate (0.115 (95% CI 0.067 to 0.190) vs. 0.391 (95% CI 0.247 to 0.556), test for subgroup difference: <i>p</i> < 0.01). This meta-analysis suggests that laparoscopy is a safe and feasible option in hemodynamic stable patients with blunt abdominal trauma.https://www.mdpi.com/2077-0383/10/9/1853laparoscopylaparotomyblunt traumapenetrating traumameta-analysis |
| spellingShingle | Young-Jun Ki Young-Goun Jo Yun-Chul Park Wu-Seong Kang The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis Journal of Clinical Medicine laparoscopy laparotomy blunt trauma penetrating trauma meta-analysis |
| title | The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis |
| title_full | The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis |
| title_fullStr | The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis |
| title_short | The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis |
| title_sort | efficacy and safety of laparoscopy for blunt abdominal trauma a systematic review and meta analysis |
| topic | laparoscopy laparotomy blunt trauma penetrating trauma meta-analysis |
| url | https://www.mdpi.com/2077-0383/10/9/1853 |
| work_keys_str_mv | AT youngjunki theefficacyandsafetyoflaparoscopyforbluntabdominaltraumaasystematicreviewandmetaanalysis AT younggounjo theefficacyandsafetyoflaparoscopyforbluntabdominaltraumaasystematicreviewandmetaanalysis AT yunchulpark theefficacyandsafetyoflaparoscopyforbluntabdominaltraumaasystematicreviewandmetaanalysis AT wuseongkang theefficacyandsafetyoflaparoscopyforbluntabdominaltraumaasystematicreviewandmetaanalysis AT youngjunki efficacyandsafetyoflaparoscopyforbluntabdominaltraumaasystematicreviewandmetaanalysis AT younggounjo efficacyandsafetyoflaparoscopyforbluntabdominaltraumaasystematicreviewandmetaanalysis AT yunchulpark efficacyandsafetyoflaparoscopyforbluntabdominaltraumaasystematicreviewandmetaanalysis AT wuseongkang efficacyandsafetyoflaparoscopyforbluntabdominaltraumaasystematicreviewandmetaanalysis |