Evidence map›Paper›PMID 30963262›Full record

ArticleSurgical endoscopy2020

"Pop in a scope": attempt to decrease the rate of unnecessary nontherapeutic laparotomies in hemodynamically stable patients with thoracoabdominal penetrating injuries.

Carlos Augusto M Menegozzo, Sérgio H B Damous, Pedro Henrique F Alves, Marcelo C Rocha, Francisco S Collet E Silva, Thiago Baraviera, Mark Wanderley, Salomone Di Saverio, Edivaldo M Utiyama

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Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Carlos Augusto M MenegozzoDivision of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas, University of Sao Paulo, São Paulo, Brazil. carlosmenegozzo@gmail.com.ORCID 0000-0003-3572-8977
Sérgio H B DamousDivision of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas, University of Sao Paulo, São Paulo, Brazil.
Pedro Henrique F AlvesDivision of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas, University of Sao Paulo, São Paulo, Brazil.
Marcelo C RochaDivision of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas, University of Sao Paulo, São Paulo, Brazil.
Francisco S Collet E SilvaDivision of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas, University of Sao Paulo, São Paulo, Brazil.
Thiago BaravieraDepartment of Radiology, Hospital das Clínicas, University of Sao Paulo, São Paulo, Brazil.
Mark WanderleyDepartment of Radiology, Hospital das Clínicas, University of Sao Paulo, São Paulo, Brazil.
Salomone Di SaverioCambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Edivaldo M UtiyamaDivision of General Surgery and Trauma, Department of Surgery, Hospital das Clínicas, University of Sao Paulo, São Paulo, Brazil.
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRCambridge University Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundManagement of patients with thoracoabdominal penetrating injuries is challenging. Thoracoabdominal penetrating trauma may harbor hollow viscus injuries in both thoracic and abdominal cavities and occult diaphragmatic lesions. While radiological tests show poor diagnostic performance in these situations, evaluation by laparoscopy is highly sensitive and specific. Furthermore, minimally invasive surgery may avoid unnecessary laparotomies, despite concerns regarding complication and missed injury rates. The objective of the present study is to evaluate the diagnostic and therapeutic performance of laparoscopy in stable patients with thoracoabdominal penetrating injuries.

methodsRetrospective analysis of hemodynamically stable patients with thoracoabdominal penetrating wounds was managed by laparoscopy. We collected data regarding the profile of the patients, the presence of diaphragmatic injury, perioperative complications, and the conversion rate. Preoperative imaging tests were compared to laparoscopy in terms of diagnostic accuracy.

resultsThirty-one patients were included, and 26 (84%) were victims of a stab wound. Mean age was 32 years. Ninety-three percent were male. Diaphragmatic lesions were present in 18 patients (58%), and 13 (42%) had associated injuries. There were no missed injuries and no conversions. Radiography and computerized tomography yielded an accuracy of 52% and 75%, respectively.

conclusionLaparoscopy is a safe diagnostic and therapeutic procedure in stable patients with thoracoabdominal penetrating wound, with low complication rate, and may avoid unnecessary laparotomies. The poor diagnostic performance of preoperative imaging exams supports routine laparoscopic evaluation of the diaphragm to exclude injuries in these patients.

Indexed as

DiaphragmLaparoscopyLaparotomyPostoperative ComplicationsThoracic InjuriesWounds, StabAbdominal InjuriesAdultBrazilConversion to Open SurgeryFemaleHemodynamicsHumansMaleMedical OveruseRetrospective StudiesDiaphragmatic injuryLaparoscopyPenetrating traumaThoracoabdominal injury

Identifiers

PMID30963262
OpenAlexW2936448965

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.