A. CHEAITO1, A. CHEAITO1 1University Of California – Los Angeles,General Surgery,Los Angeles, CA, USA
Background: Emergent abdominal surgery carries a considerable risk of mortality and postoperative complications. Population-based studies evaluating laparoscopy and outcomes compared with open surgery have concentrated on elective settings. As such, data assessing emergent laparoscopic abdominal surgeries are limited. Our goal was to evaluate the current usage and outcomes of laparoscopic surgery in the emergent setting at a single tertiary academic center.
Materials and
Methods: We report a retrospective review of 165 patients who underwent emergent surgery over a 3 year period. Demographics, perioperative clinical variables evaluated. Primary outcomes (30 day mortality) and secondary outcomes (length of hospitalization, prolonged ileus, wounds infection, pneumonia, sepsis, need for secondary procedure, median operative time, conversion rate, and cost) were evaluated.
Results: A total of 16 patients died within 30 days of surgery. In all, 58 of the patients were treated with laproscopy with a 30 day mortality of 6.9% vs 11.2% for open surgery (P=0.4). 3.4% patients had pneumonia in the laproscopy group compared to 16.8% in the open group (p=0.012); 55.1 % of the open group required secondary intervention compared to only 27.6% in the laproscopy group (P=0.01). 100% of all laproscopic cases had all layers of their wound closed compared to 77.6% of open cases (P=0.01). More patients in the open group required blood transfusions compared to the laproscopic group (28% vs 8.6%, P=0.05).
Discussion: Laparoscopy has begun to be the preferred method to manage emergent surgical abdomen, but only few reports are available actually. Our analysis revealed lthat only 50% of emergent abdominal surgeries are performed laparoscopically. Outcomes following laparoscopic surgery in this setting resulted in reduced mortality, length of stay, lower complication rates, and less discharges to skilled nursing facilities. Increased adoption of laparoscopy in the emergent setting should be considered.
