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O papel da laparoscopia no trauma abdominal
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Authors
Abstract(s)
Introdução: O trauma é a principal causa de morte em indivíduos entre os 5 anos e os
45 anos. Trata-se da 5ª causa de morte em todos os grupos etários, pelo que tem um
grande impacto na saúde pública global. A respeito do trauma abdominal, este é
causado por uma ação súbita e violenta originada por múltiplos agentes que lesiona
órgãos vitais abdominais, para além de poder associar-se a outras lesões. Desta forma,
a abordagem cirúrgica, ao trauma abdominal, por via laparoscópica (uma técnica
cirúrgica minimamente invasiva) pode trazer vantagens para o doente.
Métodos: Foi realizada uma pesquisa de artigos na PubMed que abordassem as
indicações, contraindicações, complicações e critérios de conversão da laparoscopia em
trauma abdominal assim como sobre o seu papel diagnóstico e terapêutico e que
comparassem a laparoscopia à laparotomia em trauma abdominal.
Resultados: Demonstrou-se que a laparoscopia em trauma abdominal está associada a
menor risco de infeção e de complicações, um internamento de menor duração, menor
duração do tempo necessário para a realização do procedimento, uma recuperação pósoperatória mais rápida, menor dor pós-operatória, menores custos associados e um
melhor resultado estético. Em relação à laparotomia, a laparoscopia demonstrou uma
mortalidade e uma incidência de lesões não identificadas sem diferença
estatisticamente significativa, logo o uso da laparoscopia evita laparotomias
desnecessárias.
Conclusão: A laparoscopia em trauma abdominal é segura e eficaz em doentes
hemodinamicamente estáveis, fornecendo-lhe os benefícios da cirurgia minimamente
invasiva. A sua aplicação depende da experiência do cirurgião, dos recursos disponíveis
e da extensão da lesão.
Introduction: Trauma is the leading cause of death in individuals with age between 5 and 45 years. It’s the 5th cause of death in all age groups therefore it has a big impact in global public health. Concerning abdominal trauma, it’s caused by a sudden and violent action by multiple agents that injuries vital abdominal organs and it can be associated with other lesions. Therefore, laparoscopy (it’s a minimal invasive surgery) being the surgical way in which the abdominal trauma is approached can be beneficial to the patient. Methods: PubMed was searched with the intention of finding articles that approached the indications, contraindications, complications, conversion criteria for laparoscopy in abdominal trauma as well its diagnostic and therapeutic role and a comparison of laparoscopy with laparotomy in abdominal trauma. Results: Laparoscopy in abdominal trauma has showed a lower risk of infection and complications, a shorter stay at the hospital, a shorter time necessary for the performance of the procedure, a quicker recovery post-op, less pain post-op, smaller costs associated and a better cosmetic result. Comparing with laparotomy, laparoscopy has a mortality and incidence of unidentified injuries without statistical difference so performing laparoscopy avoids unnecessary laparotomies. Conclusion: Laparoscopy in abdominal trauma is safe and effective in patients hemodynamically stable, providing them with the benefits of minimal invasive surgery. Its application depends on the experience of the surgeon, the resources available e the extension of the injury.
Introduction: Trauma is the leading cause of death in individuals with age between 5 and 45 years. It’s the 5th cause of death in all age groups therefore it has a big impact in global public health. Concerning abdominal trauma, it’s caused by a sudden and violent action by multiple agents that injuries vital abdominal organs and it can be associated with other lesions. Therefore, laparoscopy (it’s a minimal invasive surgery) being the surgical way in which the abdominal trauma is approached can be beneficial to the patient. Methods: PubMed was searched with the intention of finding articles that approached the indications, contraindications, complications, conversion criteria for laparoscopy in abdominal trauma as well its diagnostic and therapeutic role and a comparison of laparoscopy with laparotomy in abdominal trauma. Results: Laparoscopy in abdominal trauma has showed a lower risk of infection and complications, a shorter stay at the hospital, a shorter time necessary for the performance of the procedure, a quicker recovery post-op, less pain post-op, smaller costs associated and a better cosmetic result. Comparing with laparotomy, laparoscopy has a mortality and incidence of unidentified injuries without statistical difference so performing laparoscopy avoids unnecessary laparotomies. Conclusion: Laparoscopy in abdominal trauma is safe and effective in patients hemodynamically stable, providing them with the benefits of minimal invasive surgery. Its application depends on the experience of the surgeon, the resources available e the extension of the injury.
Description
Keywords
Complicações Contraindições Conversão Indicações Laparoscopia Laparotomia Trauma Abdominal Trauma Abdominal Fechado Trauma Abdominal Penetrante