Use of Temporary Abdominal Closure in Non-Trauma Surgery: A Cohort Study

Area of Science:

• Emergency Medicine
• Surgical Critical Care
• Abdominal Surgery

Background:

• Limited evidence exists for laparostomy in non-trauma emergency abdominal surgery.
• Damage control surgery is common in trauma but less studied in emergencies.
• This study compares laparostomy to one-stage laparotomy in similar patients.

Purpose of the Study:

• To characterize outcomes of emergency abdominal surgery.
• To compare laparostomy versus one-stage laparotomy.
• To assess mortality and morbidity in critically ill patients.

Main Methods:

• Retrospective study of 218 adult patients (2016-2020).
• Compared delayed abdominal closure (laparostomy) with one-stage closure.
• Analyzed in-hospital mortality, ICU LOS, hospital LOS, stoma rate, and discharge destination.

Main Results:

• No significant difference in in-hospital mortality between laparostomy and one-stage laparotomy (adjusted OR 1.67, p=0.138).
• Laparostomy patients had a longer ICU LOS (4 vs. 3 days, p<0.001).
• Similar hospital LOS, discharge destination, and stoma rates were observed.

Conclusions:

• Laparostomy in emergency abdominal surgery is associated with similar in-hospital mortality rates as one-stage laparotomy.
• The procedure did not negatively impact long-term outcomes like stoma rates.
• Consideration for laparostomy in emergency abdominal surgery is warranted given comparable mortality.