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Fourteen of the 22 included studies reported a heterogeneous mix of data comparing length of stay (LOS) in different patient groups [9], [13], [18], [19], [20], [27], [28], [29], [30], [32], [34], [35]?and?[36]. Four studies only described LOS in SNOM patients and reported median stays (range) of 7.6 days (3�C29) [19]; 6 days (3�C79) [27]; 2.2 days (1�C8) [33] and 3 days (1�C24) [35]. The exclusion of two patients with spinal cord injuries from Renz et al.��s [19] group of 13 patients brought their median down to only 5.1 days (range 3�C8). The 91 patients in Inaba et al.��s [35] cohort included eight that required delayed laparotomy but no separate LOS data is available for this subgroup. Longer [http://www.selleckchem.com/products/ldk378.html selleck screening library] median LOS in patients with positive findings at laparotomy compared to those with NTL (10.5 v 6; 13 v 6; 11 v 7) were seen in three studies [9], [18]?and?[28] which was statistically significant in Velmahos et al.��s study [9]. Their cost analysis showed that for a population of 1856 patients with abdominal GSW, a policy of routine laparotomy would have meant an extra 3560 hospital patient-days and almost $10 million in extra charges compared to the policy of SNOM. In those patients that underwent [http://en.wikipedia.org/wiki/ARAF ARAF] delayed laparotomy, LOS and charges were not significantly different to those that underwent immediate laparotomy. Seven studies [13], [18], [20], [29], [30], [34]?and?[36] showed that patients successfully completing SNOM had shorter hospital stays than patients who required laparotomies (Table 2). Longer hospital admissions were seen in patients treated with immediate laparotomy compared to those treated initially with SNOM in two studies. Velmahos et al. in 2001 [9] showed a significantly reduced LOS of 4 days (��4) in all SNOM patients, compared to an average of 14 days (��13) in immediate laparotomy patients (p?[http://www.selleckchem.com/products/GDC-0941.html Selleckchem Pictilisib] (mean 11 days?��?12, n?=?87). Only one study compared the LOS between those patients undergoing immediate laparotomy and those that had a delayed operation [34] and found no difference between those patients that failed NOM (n?=?740; mean LOS of 14.4 days?��?16.6) and those treated with immediate laparotomy (n?=?9143; mean LOS 13.0 days?��?17.2). Ideally this systematic review would have included a meta-analysis of SNOM of abdominal GSW, but the quality of the available data, differing definitions of SNOM and of what constitutes an abdominal GSW all preclude this possibility. Even if these definitions had been standardised throughout the studies reviewed, the likely degree of overlap and duplication seen in the published results would have significantly reduced the validity and power of such an analysis.