Surgery for Perforated Peptic Ulcer: Is Laparoscopy a New Paradigm?

Autores da FMUP
Participantes de fora da FMUP
- Pereira, A.
- Gonçalves, D
- da Costa, EL
Unidades de investigação
Abstract
Introduction. Laparoscopic repair of perforated peptic ulcer (PPU) remains controversial mainly due to its safety and applicability in critically ill patients. The aim of this study is to compare the outcomes of laparoscopy versus laparotomy in the treatment of PPU. Methods. Single-institutional, retrospective study of all patients submitted to surgical repair of PPU between 2012 and 2019. Results. During the study period, 169 patients underwent emergent surgery for PPU. A laparoscopic approach was tried in 60 patients and completely performed in 49 of them (conversion rate 18.3%). The open group was composed of 120 patients (included 11 conversions). Comparing the laparoscopic with the open group, there were significant differences in gender (male/female ratio 7.2/1 versus 2.2/1, respectively; p = 0.009) and in the presence of sepsis criteria (12.2% versus 38.3%, respectively; p = 0.001), while the Boey score showed no differences between the two groups. The operative time was longer in the laparoscopic group (median 100' versus 80', p = 0.01). Laparoscopy was associated with few early postoperative complications (18.4% versus 41.7%, p = 0.004), mortality (2.0% versus 14.2%; p = 0.02), shorter hospital stay (median 6 versus 7 days, p. 0.001), and earlier oral intake (median 3 versus 4 days, p = 0.021). Conclusion. Laparoscopic repair of PPU may be considered the procedure of choice in patients without sepsis criteria if expertise and resources are available. This kind of approach is associated with a shorter length of hospital stay and earlier oral intake. In patients with sepsis criteria, more data are required to access the safety of laparoscopy in the treatment of PPU.
Dados da publicação
- ISSN/ISSNe:
- 2090-1453, 2090-1445
- Tipo:
- Article
- Páginas:
- 1-
- DOI:
- 10.1155/2021/8828091
- Link para outro recurso:
- www.scopus.com
Minimally Invasive Surgery Hindawi Publishing Corporation
Citações Recebidas na Web of Science: 5
Citações Recebidas na Scopus: 5
Documentos
- Não há documentos
Filiações
Keywords
- antibiotic agent; adult; age; aged; antibiotic therapy; Article; controlled study; female; gastrectomy; human; incisional hernia; intermethod comparison; laparoscopic surgery; laparotomy; length of stay; major clinical study; male; mortality; multiple organ failure; open surgery; operation duration; percutaneous drainage; postoperative complication; reoperation; respiratory tract infection; retrospective study; sepsis; septic shock; sex difference; ulcer perforation; wound dehiscence; wound infection
Proyectos asociados
Liquid Biopsy in Rectal Cancer: Applications in Neoadjuvant Therapy Monitoring
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico (Rectal Cancer) . 2020
Doença de Crohn na Criança: Indicações Cirúrgicas
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico (Doença de Crohn) . 2020
Impact of neoadjuvant chemotherapy in the treatment of patients with gastric cancer
Investigador Principal: José Adelino Lobarinhas Barbosa
Estudo Clínico Académico (Chemotherapy) . 2020
Safety and Effectiveness of Laparoscopic Peritoneal Lavage in Hinchey III Diverticulitis
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico (Laparoscopic) . 2020
Impact of Platelet-Lymphocyte Ratio (PLR) in the prognosis of Gastric Cancer patients
Investigador Principal: Hugo Miguel Teixeira Ferraz Santos Sousa
Estudo Clínico Académico (PLR) . 2020
Prognóstico no carcinoma colorretal para além do TNM
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico (TNM) . 2020
Robotic Surgery in Rectal Cancer
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico (Robotic Surgery) . 2020
Impact of serum albumin concentration and neutrophil-lymphocyte ratio score on gastric cancer prognosis
Investigador Principal: Hugo Miguel Teixeira Ferraz Santos Sousa
Estudo Clínico Académico (gastric cancer prognosis . 2020
Rethinking Anterior Resection of the Rectum: Minimizing the Risk of Leakage
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico . 2020
Health related Quality of Life six years after bariatric surgery: factors influencing outcome
Investigador Principal: André Manuel Costa Pinho
Estudo Clínico Académico . 2020
High-Sensitivity modified Glasgow Prognostic Score (HS-mGPS) as a predictor of overall survival in gastric cancer patients submitted to curative-intent surgery
Investigador Principal: Hugo Miguel Teixeira Ferraz Santos Sousa
Estudo Clínico Académico . 2020
PD-1 blockade as a future treatment for colorectal cancer with microsatellite instability
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico . 2020
Qualidade de vida pós-cirurgica e resultados no tratamento da acalásia
Investigador Principal: José Adelino Lobarinhas Barbosa
Estudo Clínico Académico . 2020
Impact of Metabolic Surgery in Cancer Prevention / Impacto da Cirurgia Metabólica na Prevenção de Cancro
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico . 2020
Medicação associada à colite isquémica
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico . 2020
I-FABP marcador molecular de isquemia intestinal precoce
Investigador Principal: Laura Elisabete Ribeiro Barbosa
Estudo Clínico Académico . 2020
Citar a publicação
Pereira A,Sousa HS,Gonçalves D,da EL,Pinho A,Barbosa E,Barbosa J. Surgery for Perforated Peptic Ulcer: Is Laparoscopy a New Paradigm?. Minimally Invasive Surg. 2021. 2021. p. 1-1.