Successful non-operative management of blunt abdominal trauma in highly selective cases. A safe and effective choice [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-83404 | DOI: 10.5505/tjtes.2017.83404  

Successful non-operative management of blunt abdominal trauma in highly selective cases. A safe and effective choice

Georgios Theodoros Liagkos1, Charalampos Spyropoulos2, Gerasimos Tsourouflis3, Aris Papadopoulos1, Paulos Ioannides1, Constantine Vagianos3
11st Department of Surgery, Nikaia General Hospital, Nikaia, Piraeus, Greece
23rd Department of Surgery, Iaso General Hospital, Holargos, Athens, Greece
32nd Propedeutic Department of Surgery, Laikon Hospital, National & Kapodestrian University of Athens, Greece

Background: Non-operative management (NOM) of abdominal injuries has gained wide acceptance over the last decades. The current study evaluates the efficacy of ΝΟΜ in blunt abdominal trauma (BAT) at a regional Hellenic hospital.
Methods: We analyzed the results of a pre-decided treatment protocol, which was applied to all patients hospitalized for BAT, from 2008 to 2015. The protocol proposed NOM in hemodynamically stable patients with no signs of peritonitis. The demographic characteristics, type of injury, injured organ(s), type of management (operative vs. non-operative), Injury Severity Score (ISS), morbidity, mortality rates and health costs were evaluated.
Results: One hundred and forty-six patients hospitalized due to BAT at our department were included. Among them, 49 were operated and 97 were subjected to NOM. Although ISS was statistically higher in the surgical group, the severity of injuries in liver, spleen and kidneys was not different between the two groups. Surprisingly, no case subjected to NOM required conversion to operative management (OM), probably due to the strict inclusion criteria for NOM.
Conclusion: Patients with hemodynamic stability and normal physical examination may be treated non-operatively, independently of the grade of injury, in highly selective cases. ISS score is an independent risk factor for surgical treatment.

Keywords: Non-operative management, hemodynamic stability, blunt abdominal trauma

Corresponding Author: Georgios Theodoros Liagkos, Greece

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