Role of Laparoscopy in Acute Abdomen
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- The pre- operative diagnosis was compared with laparoscopic diagnosis to evaluate accuracy of diagnostic laparoscopy. With the use of diagnostic laparoscopy a diagnosis could be reached in 49 (98%) cases. It confirmed the diagnosis in 35 (70%) patients.In 14 patients (28%) laparoscopy changed the diagnosis.
研究概览
简要总结
Acute abdomen continues to be the commonest complaint for emergency surgical admission and demands a large portion of the general surgeons workload. Patients selected for this study were admitted with surgical causes of acute abdomen. Based on clinical history and examination, relevant investigations of patients with acute abdomen were done. A detailed proforma was used to collect this information. After initial assessment and informed written consent, they were subjected to laparoscopy. All patients were informed about the risk and benefit of procedure and also about the probability of laparotomy if need arose. The preoperative diagnosis was compared with laparoscopic diagnosis to evaluate accuracy of diagnostic laparoscopy. Wherever possible, therapeutic procedure was undertaken. If the therapeutic procedure required conversion to open procedure (laparotomy) the same was done. The patients were managed in Intensive Care Unit or surgical wards. The patients were followed postoperatively till 6 months.The patient were thus divided into three groups after undergoing diagnostic laparoscopy. The patients undergoing therapeutic laparoscopy, those who had laparoscopic assisted procedure done and those patients on whom laparoscopy was converted to laparotomy. The parameters compared were operating time, hospital stay and complication.
Diagnostic laparoscopy was found to be more accurate than preoperative diagnosis. Laparoscopy was found to decrease the time of procedure and duration of hospital stay. By exact diagnosis, diagnostic laparoscopy prevents non- therapeutic laparotomy. Laparoscopic assisted procedures also serve as a bridge between laparoscopy and laparotomy as it reduces operating time and their is faster postoperative recovery. Laparoscopy is an helpful tool for the diagnosis and treatment of surgical abdominal emergencies in patients especially in right lower abdominal pain, small bowel pathology and gallbladder and liver pathologies. The usage of laparoscopy is further widened by its application in the case of abdominal trauma.
Laparoscopy was found to be of great diagnostic value and a therapeutic procedure was feasible in significant number of patients. Moreover, observation on laparoscopy changed the further course of management in several cases.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 14.00 Year(s) 至 75.00 Year(s)（—）
- 性别
- All
入选标准
- •Acute abdominal pain of recent onset.
- •Patients whose age is 14 years and above.
- •Patients giving consent for surgical procedure.
排除标准
- •Uncontrolled coagulopathy.
- •Haemodynamically unstable patients.
- •Patients presenting with chronic abdominal pain.
- •Patients having undergone multiple previous abdominal procedures.
- •Patients refusing the minimal access technique (diagnostic laparoscopy) for diagnosis.
- •Other causes which exclude laparoscopy in acute abdomen.
- •(e.g. multiple stab wounds)
- •Patients undergoing elective procedures.
结局指标
主要结局
The pre- operative diagnosis was compared with laparoscopic diagnosis to evaluate accuracy of diagnostic laparoscopy. With the use of diagnostic laparoscopy a diagnosis could be reached in 49 (98%) cases. It confirmed the diagnosis in 35 (70%) patients.In 14 patients (28%) laparoscopy changed the diagnosis.
时间窗: The Laparoscopic/ post operative diagnosis was compared with pre- operative diagnosis after each procedure.
50 patients with surgical acute abdomen were selected for this study.
时间窗: The Laparoscopic/ post operative diagnosis was compared with pre- operative diagnosis after each procedure.
次要结局
- In our series 28 (56%) laparoscopic appendectomy were performed.(Therapeutic laparoscopy was done in 37 (74%) cases. Lap assisted procedure were done in 4 (8%) cases. 8 (16%) cases required conversion to open procedure. Hence, the conversion rate was 16%. The main causes for conversion were due to extensive adhesions, distended bowel.)