Laparoscopic versus open repair of perforated peptic ulcer: Improving outcomes utilizing a standardized technique

Siow, Sze Li and Mahendran, Hans Alexander and Wong, Cheeming and Hardin, Mark O. and Luk, Tienloong (2016) Laparoscopic versus open repair of perforated peptic ulcer: Improving outcomes utilizing a standardized technique. Asian Journal of Surgery. ISSN 10159584

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Abstract

Background/Objective: The objective of this study was to compare the outcomes of patients who underwent laparoscopic and open repair of perforated peptic ulcers (PPUs) at our institution. Methods: This is a retrospective review of a prospectively collected database of patients who underwent emergency laparoscopic or open repair for PPU between December 2010 and February 2014. Results: A total of 131 patients underwent emergency repair for PPU (laparoscopic repair, . n=63, 48.1% vs. open repair, . n=68, 51.9%). There were no significant differences in baseline characteristics between both groups in terms of age (p=0.434), gender (p=0.305), body mass index (p=0.180), and presence of comorbidities (p=0.214). Both groups were also comparable in their American Society of Anesthesiologists (ASA) scores (p=0.769), Boey scores 0/1 (p=0.311), Mannheim Peritonitis Index > 27 (p=0.528), shock on admission (p . <. 0.99), and the duration of symptoms > 24 hours (p=0.857). There was no significant difference in the operating time between the two groups (p=0.618). Overall, the laparoscopic group had fewer complications compared with the open group (14.3% vs. 36.8%, . p=0.005). When reviewing specific complications, only the incidence of surgical site infection was statistically significant (laparoscopic 0.0% vs. open 13.2%, . p=0.003). The other parameters were not statistically significant. The laparoscopic group did have a significantly shorter mean postoperative stay (p=0.008) and lower pain scores in the immediate postoperative period (p . <. 0.05). Mortality was similar in both groups (open, 1.6% vs. laparoscopic, 2.9%, . p < 0.99). Conclusion: Laparoscopic repair resulted in reduced wound infection rates, shorter hospitalization, and reduced postoperative pain. Our single institution series and standardized technique demonstrated lower morbidity rates in the laparoscopic group

Item Type: Article
Uncontrolled Keywords: Laparoscopic, Open, Perforated peptic ulcer, Standardized technique, Surgical outcomes, research, Universiti Malaysia Sarawak, unimas, university, universiti, Borneo, Malaysia, Sarawak, Kuching, Samarahan, ipta, education
Subjects: R Medicine > R Medicine (General)
R Medicine > RD Surgery
Divisions: Academic Faculties, Institutes and Centres > Faculty of Medicine and Health Sciences
Depositing User: Ibrahim
Date Deposited: 17 Feb 2017 02:08
Last Modified: 17 Feb 2017 02:08
URI: http://ir.unimas.my/id/eprint/15337

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