Laparoscopy safe and effective for stable pediatric patients with abdominal trauma
Korea: For stable pediatric patients with abdominal trauma, laparoscopy showed favorable outcomes, a recent study in the Journal of Clinical Medicine has revealed. There were no missed injuries and for the majority of the patients avoiding laparotomy was possible.
"The extrapolation of the results however was limited by the substantial risk of bias and lack of randomized control trials," Yun Chul Park, Chonnam National University, Gwangju, Korea, and colleagues wrote in their study. "Nevertheless, in selective patients, laparoscopy appears to be a safe and effective option."
The systematic review and meta-analysis were conducted with the objective to investigate the efficacy and safety of laparoscopy for pediatric patients with abdominal trauma. The researchers searched the online databases until 7 December 2021 for obtaining relevant articles.
Meta-analyses were performed using odds ratio (OR) for binary outcomes, standardized mean differences (SMDs) for continuous outcome measures, and overall proportion for single proportional outcomes. A total of 9 studies consisting of 12,492 patients were included in the meta-analysis.
The study led to the following findings:
- The meta-analysis showed younger age (SMD −0.47), lower injury severity score (SMD −0.62), shorter hospital stay (SMD −0.55), fewer complications (OR 0.375), and lower mortality rate (OR 0.055) in the laparoscopy group compared to the laparotomy group.
- The majority of patients were able to avoid laparotomy (0.816).
- There were no missed injuries during the laparoscopic procedures in seven eligible studies.
- Laparoscopy for stable pediatric patients showed favorable outcomes in terms of morbidity and mortality.
- There were no missed injuries, and laparotomy could be avoided for the majority of patients.
Laparoscopy for stable pediatric patients showed favorable outcomes in terms of mortality and morbidity. Avoiding laparotomy was possible for the majority of the patients and there were no missed injuries.
"The substantial risk of bias and lack of randomized control trials however limit the extrapolation of the result," the authors wrote. "Nevertheless, laparoscopy appears to be a safe and effective option in selective patients."
Reference:
Park, Y.C.; Jo, Y.G.; Ki, Y.-J.; Kang, W.S.; Kim, J. Efficacy and Safety of Laparoscopy for Mild and Moderate Pediatric Abdominal Trauma: A Systematic Review and Meta-Analysis. J. Clin. Med. 2022, 11, 1942. https://doi.org/10.3390/jcm11071942
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