{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:04:32Z","timestamp":1790251472108,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Advances in imaging, non\u2010operative management, and endovascular techniques have reshaped abdominal trauma care, but their impact on operative trends in blunt\u2010dominant Australian trauma systems is incompletely described.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n To describe temporal trends in operative and minimally invasive management of abdominal trauma at an Australian Level 1 trauma centre, and to discuss their implications.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective study of the Alfred Health Trauma Registry (2001\u20132024) identified adult major trauma (MT) patients (ISS\u2009>\u200912) undergoing emergency laparotomy, laparoscopy, or solid\u2010organ embolisation within 24\u2009h of admission. Temporal trends were assessed using linear regression and offset Poisson models. Sensitivity analyses used abdominal AIS \u2265\u20092 as the denominator.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 25\u2009497 major trauma patients, 1330 (5.2%) underwent laparotomy, 107 (0.4%) laparoscopy, and 417 (1.6%) embolisation. Annual major trauma presentations increased from 643 to 1498, while the number of patients with abdominal AIS \u2265\u20092 also rose. Laparotomy rates declined significantly over time, from 10.7% to 2.7% of major trauma admissions (R\n 2<\/jats:sup>\n \u2009=\u20090.80;\n p<\/jats:italic>\n \u2009<\u20090.01), with the decline persisting when abdominal AIS \u2265\u20092 was used as the denominator. Embolisation increased significantly, whereas laparoscopy volumes rose numerically but did not demonstrate a consistent statistically significant temporal increase.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Emergency trauma laparotomies have declined despite increasing trauma volume and abdominal injury burden, consistent with greater use of selective non\u2010operative and endovascular strategies. These changes have implications for maintaining operative readiness within contemporary multidisciplinary trauma systems.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ans.70654","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T12:28:31Z","timestamp":1775219311000},"page":"2361-2370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Two Decades of Evolution in Abdominal Trauma Surgery: Trends, Outcomes, and Implications From an Australian Level 1 Trauma Centre"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7389-9657","authenticated-orcid":false,"given":"Michael","family":"Noonan","sequence":"first","affiliation":[{"name":"National Trauma Research Institute Melbourne Australia"},{"name":"Emergency & Trauma Centre, the Alfred Hospital Melbourne Australia"},{"name":"Trauma Service, the Alfred Hospital Melbourne Australia"},{"name":"School of Translational Medicine, Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ee\u2010Jun","family":"Ban","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute Melbourne Australia"},{"name":"Trauma Service, the Alfred Hospital Melbourne Australia"},{"name":"School of Translational Medicine, Monash University Melbourne Australia"},{"name":"Acute General Surgery Unit, the Alfred Hospital Melbourne Australia"},{"name":"Hepatobiliary Surgery Unit, the Alfred Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Huynh","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute Melbourne Australia"},{"name":"Trauma Service, the Alfred Hospital Melbourne Australia"},{"name":"School of Translational Medicine, Monash University Melbourne Australia"},{"name":"Acute General Surgery Unit, the Alfred Hospital Melbourne Australia"},{"name":"Hepatobiliary Surgery Unit, the Alfred Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H. C.","family":"Pilgrim","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute Melbourne Australia"},{"name":"School of Translational Medicine, Monash University Melbourne Australia"},{"name":"Hepatobiliary Surgery Unit, the Alfred Hospital Melbourne Australia"},{"name":"School of Public Health and Preventative Medicine, Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1552-5470","authenticated-orcid":false,"given":"Gerard S.","family":"Goh","sequence":"additional","affiliation":[{"name":"School of Translational Medicine, Monash University Melbourne Australia"},{"name":"Department of Radiology The Alfred Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey W.","family":"Lai","sequence":"additional","affiliation":[{"name":"Trauma Service, the Alfred Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0183-7761","authenticated-orcid":false,"given":"Mark","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute Melbourne Australia"},{"name":"Trauma Service, the Alfred Hospital Melbourne Australia"},{"name":"School of Translational Medicine, Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199309000-00008"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.145.6.1191"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-020-01405-1"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182702afc"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2024-001650"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318270160d"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.138.5.475"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199805000-00011"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000046256.80836.AA"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2020-000667"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-07169-z"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2010.05.044"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.16194"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-021-00396-7"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-019-0257-y"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2004.02.025"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182011089"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70654","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70654","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70654","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:16:06Z","timestamp":1790248566000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70654"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,3]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/ans.70654"],"URL":"https:\/\/doi.org\/10.1111\/ans.70654","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,3]]},"assertion":[{"value":"2025-12-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}