A Study Comparing Peptic Perforation Repair Open Versus Laparoscopic Surgery
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 3, Pages 712-716
Abstract
Perforated peptic ulcers (PPUs) is related with short-term mortality and morbidity in up to 30 and 50% of peptic ulcer patients, respectively, due to subsequent peritonitis and sepsis. Immediate surgery is the most important aspect of treatment since delay in surgery considerably increases mortality. We conducted this study with an aim to compare the intraoperative findings and postoperative outcomes of cases undergoing open repair surgical approach and laparoscopic repair surgical approach for PPUs.Methods
We conducted this retrospective study in the department of General Surgery at the tertiary care hospital, North India 3 months (June 2021 to August 2021). The cases of both gender (age 15-70 years) with criteria of clinical diagnosis and radiological evidence of perforated peptic ulcer were the study subjects [treated with open repair method (n=90) or laparoscopic repair method (n=160)]. In our hospital, a thorough clinical examination was performed in all patients with PPU. A pretested proforma was designed to collect the details of cases from the patient case sheet. The collected data was entered in MS Excel sheet and was analysed using the same. Tests were considered significant if p>0.05.
Results
In present study, the cases underwent open and laparoscopic repair were matched for the gender, age, body mass index, comorbidity, and ASA score for comparing the outcomes of open and laparoscopic repair of the PPU. In our study, the operative time was significantly higher in cases whose PPU was repaired with laparoscopic method (111.62±31.89 min) as compared to the cases who underwent open repair technique (87.46±28.95 min). In our study, the surgical site infection (SSIs) rates were higher in open repair group (14.4%) as compared to the laparoscopic repair group (5.6%). In our study, the mortality rates were higher in open repair group (3.3%) as compared to the laparoscopic repair group (0.0%).
Conclusion
A common surgical emergency is a perforated peptic ulcer. In order to repair the defect and flush the peritoneal cavity, patients with perforated peptic ulcer disease typically need emergency surgery. Fewer postoperative complications including a lower rate of surgical site infection and lower mortality are advantages of laparoscopic surgery versus open surgery.
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