LAPAROSCOPIC SURGERY: A PARADIGM SHIFT IN THE TREATMENT OF ACUTE ABDOMINAL EMERGENCIES
Abstract
Introduction: Laparoscopic surgery has revolutionized the management of abdominal emergencies, offering a minimally invasive alternative with a history of skepticism that turned to widespread acceptance after the 1980s' technological advancements. Its adoption in emergencies draws from its elective success, touting reduced incision sizes, diminished pain, lower infection risks, and expedited recovery.
Material & Method: This retrospective study analyzed clinical records from Târgu Mureș County Clinical Emergency Hospital's General Surgery Department I over eight years. It focused on laparoscopic versus open surgical approaches for various abdominal emergencies, excluding thoracic, vascular, and traumatic cases. Data encompassed demographic details, operative duration, postoperative complications, conversion rates, and hospitalization length, analyzed using Graph Pad Prism and EasyMedStats©, with ethical oversight by SCJU Clinical Hospital Tg. Mures.
Results: Laparoscopic procedures outnumbered open surgeries, with appendicitis being the most common emergency. Notably, laparoscopic approaches saw fluctuating but generally declining admissions from 2014 to 2021, mainly due to the COVID-19 pandemic. Operative times were shorter for laparoscopy across all procedures, with hospital stays also reduced for laparoscopic methods except in incisional hernia repairs, where times were comparable. Conversion rates varied, with hernia repairs least likely to convert and appendectomies most likely.
Conclusion: The study underscores the preferential role of laparoscopy in emergency surgical care, aligning with shorter operative times and hospital stays. Despite higher conversion rates for certain conditions, the benefits of laparoscopy remain compelling. Ongoing advancements in laparoscopic technology will further solidify its pivotal role in modern surgical practice.
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