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Titolo:
Bedside laparoscopy in the ICU: Report of four cases
Autore:
Rosin, D; Haviv, Y; Kuriansky, J; Segal, E; Brasesco, O; Rosenthal, RJ; Shabtai, M; Ayalon, A;
Indirizzi:
Chaim Sheba Med Ctr, Dept Gen Surg & Transplantat, IL-52621 Tel Hashomer, Israel Chaim Sheba Med Ctr Tel Hashomer Israel IL-52621 21 Tel Hashomer, Israel
Titolo Testata:
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES-PART A
fascicolo: 5, volume: 11, anno: 2001,
pagine: 305 - 309
SICI:
1092-6429(200110)11:5<305:BLITIR>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTENSIVE-CARE-UNIT; DIAGNOSTIC LAPAROSCOPY; CRITICALLY ILL; ABDOMINAL SEPSIS; PERITONITIS; PNEUMOPERITONEUM; LAPAROTOMY; SURGERY; MODEL; PATIENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Rosin, D Chaim Sheba Med Ctr, Dept Gen Surg & Transplantat, IL-52621 Tel Hashomer, Israel Chaim Sheba Med Ctr Tel Hashomer Israel IL-52621 shomer, Israel
Citazione:
D. Rosin et al., "Bedside laparoscopy in the ICU: Report of four cases", J LAP ADV A, 11(5), 2001, pp. 305-309

Abstract

Background: Patients in the intensive care unit (ICU) may suffer from life-threatening abdominal pathologies, which may necessitate a surgical intervention. Diagnosis may be difficult, as deep sedation and analgesia often mask symptoms, and physical examination is unreliable. Imaging studies are not accurate enough, and exploratory laparotomy carries significant morbidityand mortality rates in this patient population. The unstable patient is difficult to mobilize to the imaging department or to the operating room. Bedside laparoscopy may overcome these difficulties. Patients and Methods: We describe our initial experience with the use of bedside laparoscopy in critical patients with suspected abdominal pathology. The procedure was performed in four patients over a 4-month period and completed in all four. Results: The findings were: turbid fluid consistent with viscus perforation in a patient with unexplained sepsis after cardiac surgery, sterile hemorrhagic fluid in a patient with malignancy and thrombotic thrombocytopenia purpura, a retroperitoneal mass from which biopsies were taken in a patient with sudden respiratory failure, and abdominal abscess in a patient after bowel resection for mesenteric embolism. None of these patients had a laparotomy after the laparoscopy. Patients 1 and 4 died a few hours after the procedure from sepsis, and patients 2 and 3 died several days later. Conclusion: Bedside laparoscopy in the ICU is feasible, informative, and accurate. It has a role in diagnosing abdominal pathologies and planning further treatment. It may avert a nontherapeutic laparotomy. Unfortunately, the prognosis in these patients is poor. Earlier use of this diagnostic modality may improve patient outcome.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 20:34:54