Relationship between the anatomical location and the selective non-operative management of penetrating stab wounds in the abdomen.

Autor: Tudela Lerma M; Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: matuler@hotmail.com., Turégano Fuentes F; Hospital General Universitario Gregorio Marañón, Madrid, España., Pérez Díaz MD; Hospital General Universitario Gregorio Marañón, Madrid, España., Rey Valcárcel C; Hospital General Universitario Gregorio Marañón, Madrid, España., Martín Román L; Hospital General Universitario Gregorio Marañón, Madrid, España., Ruiz Moreno C; Hospital General Universitario Gregorio Marañón, Madrid, España., Fernández Vázquez ML; Hospital General Universitario Gregorio Marañón, Madrid, España., Fernández Martínez M; Hospital General Universitario Gregorio Marañón, Madrid, España.
Jazyk: English; Spanish; Castilian
Zdroj: Cirugia espanola [Cir Esp (Engl Ed)] 2021 Feb 13. Date of Electronic Publication: 2021 Feb 13.
DOI: 10.1016/j.ciresp.2020.12.003
Abstrakt: Introduction: The relationship between the anatomical location of penetrating abdominal stab wounds (SW) and the rate of selective non-operative management (SNOM) based on that location is scarcely reflected in the specialized literature. Our main objective has been to assess this rate based on the anatomical location, and our results.
Methods: Retrospective review of a prospective registry of abdominal trauma from April 1993 to June 2020. The two study groups considered were the Operative Management (OM), and the SNOM, including in this one the use of diagnostic laparoscopy. Penetrating SWs in the abdomen were classified according to anatomical location.
Results: We identified 259 patients who fulfilled the inclusion criteria. SNOM was applied in 31% of the patients with a success rate of 96%, and it was more frequent in the lumbar, flank, and thoraco-abdominal regions; within the anterior abdomen it was more applicable in the RUQ, followed by the LUQ and epigastrium, respectively. An unnecessary laparotomy was done in 21% of patients, with the highest number in the epigastrium. Taking into account the unnecessary laparotomies and the rates of successful SNOM, 70,5% of lumbar, el 66,5% of epigastric, 62% of flank, and 59% of RUQ penetrating SWs could have been managed without a laparotomy.
Conclusions: SNOM of penetrating SWs in the abdomen has been safer and more applicable in those located in the lumbar, flank, epigastric, and RUQ regions.
(Copyright © 2020 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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