{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:30:52Z","timestamp":1784014252947,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T00:00:00Z","timestamp":1662249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T00:00:00Z","timestamp":1662249600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T00:00:00Z","timestamp":1662249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The discussion is ongoing about appropriate indications for laparoscopic surgery in trauma patients. As timing and risks of conversion to laparotomy remain unclear, we aimed to elucidate characteristics of and risks for conversion following laparoscopic surgery, using a nationwide database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational study was conducted, using Japanese Trauma Data Bank (2004\u20132018). We included adult trauma patients who underwent laparoscopic surgery as an initial surgical intervention. Conversion to laparotomy was defined as laparotomy at the initial surgery. Patient demographics, mechanism and severity of injury, injured organs, timing of surgery, and clinical outcomes were compared between patients with and without conversion. Risks for conversion were analyzed focusing on indications for laparoscopic surgery, after adjusting patient and institution characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 444 patients eligible for the study, 31 required conversions to laparotomy. The number of laparoscopic surgeries gradually increased over the study period (0.5\u20134.5% of trauma laparotomy), without changes in conversion rates (5\u201310%). Patients who underwent conversion had more severe abdominal injuries compared with those who did not (AIS 3 vs 2). While length of hospital stay and in\u2010hospital mortality were comparable, abdominal complications were higher among patients with conversion (12.9 vs. 2.9%), particularly when laparoscopy was performed for peritonitis (OR, 22.08 [5.11\u201395.39]). A generalized estimating equation model adjusted patient background and identified hemoperitoneum and peritoneal penetration as risks for conversion (OR, 24.07 [7.35\u201378.75] and 8.26 [1.20\u2013 56.75], respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Trauma laparoscopy for hemoperitoneum and peritoneal penetration were associated with higher incidence of conversion to open laparotomy.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06714-7","type":"journal-article","created":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T18:02:32Z","timestamp":1662314552000},"page":"2616-2624","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Characteristics of Laparoscopic Surgery for Trauma Patients and Risks of Conversion to Open Laparotomy"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8772-9600","authenticated-orcid":false,"given":"Ryo","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Trauma Service\/Department of Emergency and Critical Care Medicine Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku, Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon F.","family":"Cestero","sequence":"additional","affiliation":[{"name":"Department of Surgery UT Health San Antonio San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Kameyama","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery KKR Tachikawa Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i1.1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i2.668"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010014\u20102793\u20107"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010012\u20101790\u2010y"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002130"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2014.12.011"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010020\u201007687\u20101"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000379"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2017.0562"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.15140"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010017\u20105812\u20106"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20103212\u20104"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003239"},{"key":"e_1_2_10_15_1","volume-title":"Advanced trauma life support: student course manual","author":"American College of Surgeons, Committee on Trauma","year":"2018"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.8014"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000199961.02677.19"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000197906.28846.87"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2018.05.033"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072\u20107515(99)00052\u20106"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010014\u20102904\u20105"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010018\u20106436\u20101"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000000466"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002979"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004557"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002353"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010017\u20101585\u20100"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010007\u20109550\u2010z"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/1457496918816927"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-022-06714-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-022-06714-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-022-06714-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-022-06714-7","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T17:07:45Z","timestamp":1703351265000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-022-06714-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,4]]},"references-count":28,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1007\/s00268-022-06714-7"],"URL":"https:\/\/doi.org\/10.1007\/s00268-022-06714-7","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,4]]},"assertion":[{"value":"16 August 2022","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 September 2022","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This study was approved by the Institutional Review Board of the Keio University School of Medicine (application number: 20090087). The requirement for informed consent was waived because of the anonymous nature of the data being used.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}