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Case Report
Dual repair of traumatic flank hernia using laparoscopic and open approaches: a case report
Yoonjung Heo, Dong Hun Kim
J Trauma Inj. 2022;35(1):46-50.   Published online October 25, 2021
DOI: https://doi.org/10.20408/jti.2021.0008
  • 4,305 View
  • 98 Download
AbstractAbstract PDFSupplementary Material
Traumatic flank hernia (TFH) is rare and prone to recurrence, which makes appropriate treatment challenging. No current guidelines define the optimal timing and method of repair. Meanwhile, recent advances in laparoscopic techniques are reshaping the options for the treatment of TFH. A dual approach that utilizes both laparoscopic and open methods has not previously been reported. Herein, we present the successful treatment of TFH after blunt trauma. A 46-year-old male patient underwent elective herniorrhaphy on hospital day 3, in which laparoscopic implantation of a sublay mesh and extracorporeal implantation of an onlay mesh were performed. Such techniques may be appropriate and result in feasible outcomes in hemodynamically stable patients with large TFH who are strongly suspected of having bowel herniation or concomitant intraperitoneal injuries. Larger studies are needed to assess the long-term results.
Summary
Original Articles
Diagnostic and Therapeutic Laparoscopy for Abdominal Trauma: A Single Surgeon’s Experience at a Level I Trauma Center
Hancheol Jo, Dong Hun Kim
J Trauma Inj. 2021;34(4):248-256.   Published online March 15, 2021
DOI: https://doi.org/10.20408/jti.2020.0081
  • 3,240 View
  • 104 Download
AbstractAbstract PDF
Purpose

Laparoscopy has various advantages over laparotomy in terms of postoperative recovery. The number of surgeons using laparoscopy as a diagnostic and therapeutic tool in abdominal trauma patients is increasing, whereas open conversion is becoming less common. This report summarizes a single surgeon’s experience of laparoscopy at a level I trauma center and evaluates the feasibility of laparoscopy as a diagnostic and therapeutic tool for abdominal trauma patients.

Methods

In total, 30 abdominal trauma patients underwent laparoscopy by a single surgeon from October 2014 to May 2020. The purpose of laparoscopy was categorized as diagnostic or therapeutic. Patients were classified into three groups by type of surgery: total laparoscopic surgery (TLS), laparoscopy-assisted surgery (LAS), or open conversion (OC). Univariate analysis was performed to determine the advantages and disadvantages.

Results

The mechanism of injury was blunt in 19 (63.3%) and penetrating in 11 patients (36.7%). Eleven (36.7%) and 19 patients (63.3%) underwent diagnostic and therapeutic laparoscopy, respectively. The hospital stay was shorter for patients who underwent diagnostic laparoscopy than for those who underwent therapeutic laparoscopy (5.0 days vs. 13.0 days), but no other surgical outcomes differed between the groups. TLS, LAS, and OC were performed in 12 (52.2%), eight (34.8%), and three patients (13.0%), respectively. There was no significant difference in morbidity and mortality among the three groups.

Conclusions

Laparoscopic surgery for selected cases of abdominal trauma may be feasible and safe as a diagnostic and therapeutic tool in hemodynamically stable patients due to the low OC rate and the absence of fatal morbidity and mortality.

Summary
Comparison of Penetrating and Blunt Traumatic Diaphragmatic Injuries
Sang Su Lee, Sung Youl Hyun, Hyuk Jun Yang, Yong Su Lim, Jin Seong Cho, Jae Hyug Woo
J Trauma Inj. 2019;32(4):210-219.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.034
  • 4,053 View
  • 94 Download
  • 2 Citations
AbstractAbstract PDF
Purpose

Traumatic diaphragmatic injury (TDI) is no longer considered to be a rare condition in Korea. This study investigated differences in the prevalence of accompanying injuries and the prognosis in patients with traumatic diaphragmatic damage according to the mechanism of injury.

Methods

We retrospectively reviewed the medical records of patients with TDI who were seen at a regional emergency medical center from January 2000 to December 2018. Among severe trauma patients with traumatic diaphragmatic damage, adults older than 18 years of age with a known mechanism of injury were included in this study. Surgery performed within 6 hours after the injury was sustained was defined as emergency surgery. We assessed the survival rate and likelihood of respiratory compromise according to the mechanism of injury.

Results

In total, 103 patients were analyzed. The patients were categorized according to whether they had experienced a penetrating injury or a blunt injury. Thirty-five patients had sustained a penetrating injury, and traffic accidents were the most common cause of blunt injuries. The location of the injury did not show a statistically significant difference between these groups. Severity of TDI was more common in the blunt injury group than in the penetrating injury group, and was also more likely in patients with respiratory compromise. However, sex, the extent of damage, and the initial Glasgow coma scale score had no significant relationship with severity.

Conclusions

Based on the findings of this study, TDI should be recognized and managed proactively in patients with blunt injury and/or respiratory compromise. Early recognition and implementation of an appropriate management strategy would improve patients’ prognosis. Multi-center, prospective studies are needed in the future.

Summary

Citations

Citations to this article as recorded by  
  • An audit of traumatic haemothoraces in a regional hospital in KwaZulu-Natal, South Africa
    CM Kithuka, VC Ntola, W Sibanda
    South African Journal of Surgery.2023; 61(3): 12.     CrossRef
  • Factors Associated with Successful Video-Assisted Thoracoscopic Surgery and Thoracotomy in the Management of Traumatic Hemothorax
    Heather M. Grant, Alexander Knee, Michael V. Tirabassi
    Journal of Surgical Research.2022; 269: 83.     CrossRef

J Trauma Inj : Journal of Trauma and Injury