NON-OPERATIVE MANAGEMENT OF ABDOMINAL TRAUMA: EXPEDIENCY, EFFICIENCY, SAFETY

Objective. Non-operative management (NOM) is one of the most promising fields in the treatment of abdominal trauma. The aim of this study was to evaluate possibility, expediency and safety of NOM. Material and methods. This study included 230 cases of laparoscopy or NOM application in abdominal trauma from January 2006 to September 2015 (single hospital experience). Of the total number of patients 58 underwent a diagnostical laparoscopy, 100 - a therapeutic one and 72 were managed non-operatively. Results. Patients with small hemoperitoneum (< 100 ml) needed an operation just in 6.5% of cases. Among the patients after laparoscopy 31.7% didn't need any therapeutic procedure. These results led us to conclusion about a possibility of non-operative management. NOM was successful in 58 of 72 (80.6%) cases. The length of hospital stay was 4.9 ±4.8 (1-16) days. Complications rate was 1 of 72. Common mortality rate was 5 (6.9%), abdominal trauma-related mortality rate - 0. In none of the cases NOM was a reason of unfounded operation delay, complication of treatment or lethal outcome. Conclusion. The initial results show an effectiveness and safety of selective non-operative management of blunt abdominal trauma.

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