ArticleSurgical endoscopy2020
Are we doing too many non-therapeutic laparotomies in trauma? An analysis of the National Trauma Data Bank.
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 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Two Decades of Evolution in Abdominal Trauma Surgery: Trends, Outcomes, and Implications From an Australian Level 1 Trauma Centre.ANZ journal of surgery · 2026Article
- Pneumoperitoneum Following Perineal Air Insufflation can be Managed Conservatively.European journal of case reports in internal medicine · 2026Article
- Declining mortality after open pelvis fracture in North America.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Single-Incision Laparoscopy in Abdominal Trauma: Current Evidence, Clinical Applications, and Evolving Role-A Narrative Review.Journal of clinical medicine · 2025Review
- Blunt and Penetrating Injury to the Bowel: A Review.Clinics in colon and rectal surgery · 2024Review
- Could trauma laparoscopy be the standard of care for hemodynamically stable patients? A retrospective analysis of 165 cases.Surgical endoscopy · 2023Article
- Efficacy and Safety of Laparoscopy for Mild and Moderate Pediatric Abdominal Trauma: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2022Article
- WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment.World journal of emergency surgery : WJES · 2022Review
- Article
- The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2021Article
- Abdominal Self-Stabbing: An Uncommon Type of Sharp Abdominal Trauma.Case reports in emergency medicine · 2021Article
- One Bullet Causing Five Holes, Laparoscopic Exploration with Repair: A Case Report and Review of the Literature.Case reports in surgery · 2020Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExploratory laparotomy (EL) has been the definitive diagnostic and therapeutic modality for operative abdominal trauma in the US. Recently, many trauma centers have started using diagnostic laparoscopy (DL) in stable trauma patients in an effort to reduce the incidence of non-therapeutic laparotomy (NL). We aim to evaluate the incidence of NL in the trauma population in the US and compare the outcomes between DL and NL.
methodsUsing ICD-9 codes, the National Trauma Data Bank (2010-2015) was queried for patients undergoing any abdominal surgical intervention. Patients were divided into two groups: diagnostic laparoscopy (DL) and exploratory laparotomy (EL). Hemodynamically unstable patients on arrival and patients with abbreviated injury score (AIS) > 3 were excluded. Patients in EL group without any codes for gastrointestinal, diaphragmatic, hepatic, splenic, vascular, or urological procedures were considered to have undergone NL. After excluding patients who were converted to open from the DL group, multivariate regression models were used to analyze the outcomes of DL vs NL group with respect to mortality, length of stay, and complications.
resultsA total of 3197 patients underwent NL vs 1323 patients who underwent DL. Compared to DL group, the NL group were older (mean age: 35 vs. 31, P < 0.01). Rate of penetrating injury was 77% vs 86% for patients in NL vs DL. On multivariate analysis, NL was associated with increased mortality (OR 4.5, 95% CI 2.1-9.7), higher rate of complications (OR 2.2, 95% CI 1.4-3.3), and a longer hospital stay (OR 2.7, 95% CI 2.1-3.5). NL was also associated with higher rates of pneumonia, VTE, ARDS, and cardiac arrest.
conclusionWith increasing experience in minimally invasive surgery, DL should be a part of the armamentarium of trauma surgeons. This study supports that in well-selected trauma patients DL has favorable outcomes compared to NL. These findings warrant further investigation.
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