C S Ou1, R Rowbotham. 1. Department of Gynecology, University of Washington School of Medicine and Northwest Hospital, Seattle, USA.
Abstract
PURPOSE: We reviewed the records of 77 women treated for nontraumatic acute abdomen by the principal author between June 1991 and June 1996. All patients presented to either the surgeon's office or the emergency room at Northwest Hospital, which is an urban community hospital in North Seattle. Our objectives in the study were to determine the effectiveness of diagnostic laparoscopy for nontraumatic acute abdomen and the percentage of cases managed using laparoscopic technique exclusively. PATIENTS AND METHODS: The mean patient age was 36.5 (range 12-65) years. The majority of these women (92%) were premenopausal. Seventy-two (93.5%) were Caucasian, and the remaining 5 (6.5%) were Asian. Thirty-eight of the women (49%) had undergone at least one prior pelvic or abdominal operation, and 28 (36%) had undergone more than one. The principal author performed preoperative clinical evaluations, then diagnostic laparoscopy for all 77 patients. RESULTS: Laparoscopy provided a definitive diagnosis in 76 of the 77 cases. In 70% of the cases (54 of 77) the preoperative diagnosis was confirmed by diagnostic laparoscopy, and in 29% (22 of 77), the diagnosis was confirmed, yet augmented or clarified, by diagnostic laparoscopy. In the remaining case, diagnostic laparoscopy ruled out any acute etiology. Ninety-five percent of the patients (72 of 76) were treated exclusively by laparoscopy (70 cases) or a laparoscopy-assisted procedure (2 cases). Four patients (5%) required conversion to laparotomy. The remaining patient required no therapeutic surgery. Mortality was 0 and morbidity 4%. CONCLUSION: A high proportion of women presenting with acute abdominal pain can be managed using a laparoscopic technique exclusively.
PURPOSE: We reviewed the records of 77 women treated for nontraumatic acute abdomen by the principal author between June 1991 and June 1996. All patients presented to either the surgeon's office or the emergency room at Northwest Hospital, which is an urban community hospital in North Seattle. Our objectives in the study were to determine the effectiveness of diagnostic laparoscopy for nontraumatic acute abdomen and the percentage of cases managed using laparoscopic technique exclusively. PATIENTS AND METHODS: The mean patient age was 36.5 (range 12-65) years. The majority of these women (92%) were premenopausal. Seventy-two (93.5%) were Caucasian, and the remaining 5 (6.5%) were Asian. Thirty-eight of the women (49%) had undergone at least one prior pelvic or abdominal operation, and 28 (36%) had undergone more than one. The principal author performed preoperative clinical evaluations, then diagnostic laparoscopy for all 77 patients. RESULTS: Laparoscopy provided a definitive diagnosis in 76 of the 77 cases. In 70% of the cases (54 of 77) the preoperative diagnosis was confirmed by diagnostic laparoscopy, and in 29% (22 of 77), the diagnosis was confirmed, yet augmented or clarified, by diagnostic laparoscopy. In the remaining case, diagnostic laparoscopy ruled out any acute etiology. Ninety-five percent of the patients (72 of 76) were treated exclusively by laparoscopy (70 cases) or a laparoscopy-assisted procedure (2 cases). Four patients (5%) required conversion to laparotomy. The remaining patient required no therapeutic surgery. Mortality was 0 and morbidity 4%. CONCLUSION: A high proportion of women presenting with acute abdominal pain can be managed using a laparoscopic technique exclusively.
Authors: Dimitrios Stefanidis; William S Richardson; Lily Chang; David B Earle; Robert D Fanelli Journal: Surg Endosc Date: 2008-09-24 Impact factor: 4.584
Authors: S Sauerland; F Agresta; R Bergamaschi; G Borzellino; A Budzynski; G Champault; A Fingerhut; A Isla; M Johansson; P Lundorff; B Navez; S Saad; E A M Neugebauer Journal: Surg Endosc Date: 2005-10-24 Impact factor: 3.453