title: A Comparison of Laparoscopy and Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  This study aimed to systematically review and compare the perioperative outcomes of laparoscopy with laparotomy for abdominal trauma patients.
  
  
  METHODS
  We conducted a systematic review and meta-analysis comparing the perioperative outcomes of laparoscopy with laparotomy for abdominal trauma patients. Clinical endpoints included length of hospital stay, operation time, amount of intraoperative blood loss, time to postoperative exhaust, time to regular diet, time to out of bed, duration of postoperative pain, postoperative complications, perioperative mortality rate, length of intensive care unit (ICU) stay, missed injuries, conversions to laparotomy, and cure rate.
  
  
  RESULTS
  Sixty-four studies including 9058 patients with abdominal trauma were included. In these studies, laparoscopy was used as a screening, diagnostic, or therapeutic tool. Meta-analysis showed significant reductions in the incidence of postoperative complications (relative risk [RR] [95 % confidence interval (CI)] 0.37 [0.29-0.46]), perioperative mortality rate (RR 0.64; 95 % CI 0.52-0.80), operation time (mean difference [MD] [95 % CI] -19.93 min [-34.43 to 5.43]), length of hospital stay (MD -5.15 days; 95 % CI -6.80 to 3.50), amount of intraoperative blood loss (MD -141.33 ml; 95 % CI -260.99 to 21.67), time to postoperative exhaust (MD -5.32 h; 95 % CI -8.60 to 2.05), time to regular diet (MD -3.46 h; 95 % CI -6.31 to 0.61), time to out of bed (MD -23.51 h; 95 % CI -24.85 to 22.16), duration of postoperative pain (MD -21.34 h; 95 % CI -22.65 to 20.03), length of ICU stay (MD -1.89 days; 95 % CI -4.05 to 0.27) in patients with abdominal trauma treated with laparoscopy compared with laparotomy. The pooled incidence of postoperative complications, missed injuries, conversions, and perioperative mortality rate of laparoscopy among the case reports were 0.04 (95 % CI 0.03-0.06), 0.01 (95 % CI 0.01-0.02), 0.24 (95 % CI 0.20-0.28), 0.01(95 % CI 0.01-0.02), respectively. Cure rate of laparoscopy ranged from 46 to 95 % and the pooled rate was 0.76 (95 % CI 0.71-0.81).
  
  
  CONCLUSIONS
  Laparoscopy is an effective way to improve perioperative outcomes and reduce the complications of hemodynamically stable patients with abdominal trauma. It is worth further popularization in clinical practice.
authors: Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, 400038, People's Republic of China.|Center for Clinical Epidemiology and Evidence-Based Medicine, Third Military Medical University, Chongqing, People's Republic of China.
authors: Yueli
authors: Y
authors: Li
authors: Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, 400038, People's Republic of China.|Center for Clinical Epidemiology and Evidence-Based Medicine, Third Military Medical University, Chongqing, People's Republic of China.
authors: Ying
authors: Y
authors: Xiang
authors: Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, 400038, People's Republic of China.|Center for Clinical Epidemiology and Evidence-Based Medicine, Third Military Medical University, Chongqing, People's Republic of China.
authors: Na
authors: N
authors: Wu
authors: Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, 400038, People's Republic of China.|Center for Clinical Epidemiology and Evidence-Based Medicine, Third Military Medical University, Chongqing, People's Republic of China.
authors: Long
authors: L
authors: Wu
authors: Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Zubin
authors: Z
authors: Yu
authors: Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, 400038, People's Republic of China.|Center for Clinical Epidemiology and Evidence-Based Medicine, Third Military Medical University, Chongqing, People's Republic of China.
authors: Mengxuan
authors: M
authors: Zhang
authors: Breast Disease Center, Southwest Hospital, Third Military Medical University, Chongqing, 400038, People's Republic of China.
authors: Minghao
authors: M
authors: Wang
authors: Breast Disease Center, Southwest Hospital, Third Military Medical University, Chongqing, 400038, People's Republic of China.
authors: Jun
authors: J
authors: Jiang
authors: Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, 400038, People's Republic of China. liyafei2008@hotmail.com.|Center for Clinical Epidemiology and Evidence-Based Medicine, Third Military Medical University, Chongqing, People's Republic of China. liyafei2008@hotmail.com.
authors: Yafei
authors: Y
authors: Li
mesh_terms: D000007:Abdominal Injuries; D016063:Blood Loss, Surgical; D006801:Humans; D007362:Intensive Care Units; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay; D061646:Operative Time; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications