The utility of diagnostic laparoscopy in the evaluation of anterior abdominal stab wounds |
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| Authors: | Tammy R. Kopelman Patrick J. O'Neill Luis H. Macias Jordy C. Cox Marc R. Matthews David A. Drachman |
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| Affiliation: | a Division of Burns, Trauma Surgery and Surgical Critical Care, Department of Surgery, Maricopa Medical Center, Phoenix, AZ 85008, United States
b Department of Research, Maricopa Medical Center, Phoenix, AZ 85008, United States |
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| Abstract: | BackgroundTo assess if diagnostic laparoscopy (DL) is superior to nonoperative modes (serial abdominal examination with/without computed axial tomography [CAT] and diagnostic peritoneal lavage) in determining the need for therapeutic laparotomy (TL) after anterior abdominal stab wound (ASW).MethodsRetrospective review of ASW patients. Patients were divided into group A (DL/exploratory laparotomy) to identify peritoneal violation (PV) and group B (initial nonoperative modes).ResultsSeventy-three patients met inclusion criteria. In group A (n = 38), 29 patients (76%) had PV by DL and underwent exploratory laparotomy. Only 10 (35%) underwent TL (sensitivity for PV = 100%; specificity and positive predictive value of PV in determining need for TL = 29% and 33%, respectively). In group B (n = 35), 7 patients (20%) underwent TL, yielding an improved specificity (96%) and positive predictive value (88%).ConclusionsWe find no role for DL in the evaluation of ASW patients solely to determine PV. |
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| Keywords: | Anterior abdominal stab wounds Diagnostic laparoscopy Computed tomography Diagnostic peritoneal lavage Hospital charges Laparotomy Length of stay Local wound exploration Nontherapeutic Serial abdominal examinations Therapeutic |
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