Prognostic influence of delays between exploratory and definitive laparotomy in the treatment of malignant ovarian tumors
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Exploratory laparotomy
Objective: Laparotomy is commonly indicated in patients presenting blunt or penetrating trauma. This cross-sectional study is designed to evaluate the frequency and the causes of laparotomy following abdominal trauma. Materials and Methods: The data of 71 patients who underwent laparotomy as a result of abdominal trauma in Shohada Ashayer Hospital, Khorramabad were evaluated and a questionnaire was completed for each patient. All the data were analyzed statistically using SPSS. Results: Of 71 patients, 61 underwent positive laparotomy whereas, negative laparotomy was performed in 10 patients. The results from this study showed that the most common organ of the injury was spleen (19.7%), followed by other solid organs. The small intestine (16.4%) was found more prone to injuries in penetrating trauma. Incidence of blunt trauma injury due to road accidents was the greatest 50.82% and 20% of penetrating traumas were the result of a firearm. Conclusion: Abdominal trauma injury is common in our study population where spleen, small intestine and other solid organs are chiefly involved. Indications of laparotomy should be fully examined in order to avoid negative laparotomies and associated complications. Keywords: trauma, blunt, laparotomy, penetrating
Exploratory laparotomy
Penetrating Trauma
Blunt trauma
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Abdominal exploration followed by vascular bypass has been the standard of care for acute mesenteric ischemia (AMI), but there is increasing use of endovascular treatment with selective exploratory laparotomy.We performed a retrospective review of patients diagnosed with AMI who underwent mesenteric artery angioplasty or stenting at a single institution from 2010-2017. Patients were divided into 3 groups: those who did not undergo exploratory laparotomy; those who received endovascular treatment before laparotomy (post-reperfusion laparotomy group); and those who had endovascular treatment after laparotomy (pre-reperfusion laparotomy group).Patients who did not undergo exploratory laparotomy showed 85.7% (12/14) survival, compared with 63.6% (7/11) in the post-reperfusion group and 25.0% (2/8) in the pre-reperfusion group, P=0.077). Time to reperfusion was significant (P=0.009) in predicting survival for patients who underwent exploratory laparotomy.Emergent endovascular treatment prior to laparotomy seems to be associated with a higher survival.
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Mesenteric Ischemia
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Objective To investigate the the optimum time of exploratory laparotomy for multiple abdominal traumas.Methods 36 patients were diagnosed rapidly after hospitalization.34 cases were suspected with multiple abdominal traumas were carried out with exploratory laparotomy.Results 2 patients without exploratory laparotomy died.Among 34 patients with exploratory laparotomy,2 patients died (5.88%) and 32 patients were cured (94.12%). Conclusion The early diagnosis of the multiple abdominal traumas and choice of the optimum time to perform exploratory laparotomy are of utmost importance to enhance the success rate of treatment of multiple abdominal traumas.
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Exploratory research
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Objective To decrease negative laparotomy in patients suffering from penetrating abdominal wounds. Methods The clinical data of 78 cases of penetrating abdominal wounds undergoing exploratory laparotomy before Jun. 1999 were retrospectively reviewed, and new indication was developed and was applied to 53 cases admitted between Jun. 1999 and Jun. 2000. Results Compared with the 91% of exploratory laparotomy in 78 cases before Jun. 1999, the rate of exploratory laparotomy of penetrating wounds of the abdomen in the 53 cases admitted after Jun. 1999 was 64%. The difference was significant(χ 2=14.51, P 0.01). Conclusions The new indication effectively decreases the negative laparotomy and is clinically applicable.
Exploratory laparotomy
Penetrating Trauma
Penetrating wounds
Acute abdomen
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Exploratory laparotomy
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Objective:To discuss the causes of transferring to open laparotomy when the laparoscopic cholecystectomy(LC) is being done, and to discuss the indication of immediate laparotomy and judge the degree of difficulty before LC. Methods:The clinical data of 11?856 cases of LC were retrospectively analyzed.Results:The occurrence rate of transferring was 2 41%. The main causes were the patient's history of acute cholecystitis and recent acute outbreak, adhesion around gallbladder, stone incaracration on the neck of gallbladder and unclear discrimination of Calot's triangle, and damage in choledochus. Conclusions:It must be careful to choose the indication of LC,if the patient has history of acute cholecystitis or recent acute outbreak. It's an important step that surgeon predominate correctly opportunity and operable way of immediate laparotomy so as to decrease complication of LC.
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Purpose Negative laparotomy in patients with abdominal penetrating injuries (APIs) is associated with deleterious outcomes and unnecessary expense; however, the indications for laparotomy in hemodynamically stable patients with ambiguous computed tomography (CT) findings remain unclear. This study aimed to identify the factors associated with negative laparotomy. findings Methods Data of patients who underwent laparotomy for APIs between 2011 and 2019 were retrospectively reviewed. Patients who presented with definite indications for laparotomy were excluded. The patients were dichotomized into negative and positive laparotomy groups, and the baseline characteristics, laboratory test results, and CT findings were compared between the groups. Results Of 55 patients with ambiguous CT findings, 38 and 17 patients were assigned to the negative and positive laparotomy groups, respectively. There was no significant difference between the groups with respect to the baseline characteristics or the nature of the ambiguous CT findings. However, the laboratory test results showed that there was a difference in the percentage of neutrophils between the groups (negative: 55.6% [range 47.4â66.1%] vs. positive: 79.8% [range 77.6â88.2%], p<0.001), although the total white blood cell count was not significantly different. The mean duration of hospital stay for the negative laparotomy group was 13.1 days, and seven patients (18.4%) experienced complications. Conclusions Diagnostic factors definitively indicative of laparotomy were not identified, although the percentage of neutrophils might be helpful. However, routine laparotomy in patients with peritoneal injuries could result in instances of negative laparotomy. Keywords: Abdominal injuries; Wounds, penetrating; Laparotomy
Abdominal computed tomography
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Objective To decrease negative laparotomy in patients suffering from penetrating abdominal wounds. Methods The clinical data of 121 patients of penetrating abdominal wounds undergoing exploratory laparotomy form Jun. 1997 to Oct. 2004 were retrospectively reviewed. Results As absolutely acute indications of patients suffering from penetrating abdominal wounds, the rate of negative laparotomy was 32.2%(39/121). Conclusions None all of the patients suffering from penetrating abdominal wounds need acute operation. The rational acute indications effectively decrease the negative laparotomy
Exploratory laparotomy
Penetrating wounds
Penetrating Trauma
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