Laparoscopic Versus Open Repair of Peptic Ulcer Perforation

Watumiaji waliosajiliwa tu ndio wanaweza kutafsiri nakala

Ingia / Ingia

Kiungo kimehifadhiwa kwenye clipboard

Hali

Wadhamini

Gianluca Costa

JARIBIO LA KLINIKI: NCT04447170

BioSeek: nct04447170

Maneno muhimu

Kikemikali

Although laparoscopic repair (LR) of perforated peptic ulcers (PPUs) has long been accepted, clinical evidence comparing LR versus open repair (OR) remains lacking. The aim of this study is to evaluate the feasibility, safety and outcome of laparoscopic gastric repair and compare it with the outcome open repair by relying on a propensity score matching statistical technique

Maelezo

Despite the evolution of medical management of Gastroduodenal Peptic Ulcer (GPU), complications like bleeding and perforation are still not uncommon in clinical practice. According to the literature in average, 2-14% of peptic ulcers result in perforation, most 215 commonly occurring in females over the age of 60 and chronic NSAID, alcohol or tobacco users.

Management of perforated peptic ulcer entails resuscitation, pharmacotherapy and surgery.

Traditionally, suture with or without omental patch has been considered the 'gold standard' and still is. It is associated with shorter length of stay, lower transfusion needs and has lower morbidity as compared to gastrectomy. In 1992, it has been proposed that laparoscopy should be routinely considered in the management of perforated duodenal ulcer. Nowadays due to the advances in laparoscopic technique, many publications suggest that laparoscopic repair of perforated peptic ulcers could be a superior choice to open repair. These is linked with the advantages of laparoscopic surgery over open surgery such as reduced postoperative pain, lower wound infection rate, decreased length of hospital stay, and earlier functional recovery

Tarehe

Imethibitishwa Mwisho:	05/31/2020
Iliyowasilishwa Kwanza:	06/18/2020
Uandikishaji uliokadiriwa Uliwasilishwa:	06/22/2020
Iliyotumwa Kwanza:	06/24/2020
Sasisho la Mwisho Liliwasilishwa:	06/22/2020
Sasisho la Mwisho Lilichapishwa:	06/24/2020
Tarehe halisi ya kuanza kwa masomo:	08/31/2020
Tarehe ya Kukamilisha Msingi iliyokadiriwa:	12/30/2020
Tarehe ya Kukamilisha Utafiti:	08/31/2021

Hali au ugonjwa

Surgery

Emergencies

Peptic Ulcer Perforation

Uingiliaji / matibabu

Procedure: Laparoscopic repair

Awamu

Vikundi vya Arm

Mkono	Uingiliaji / matibabu
Laparoscopic repair Patients undergoing laparoscopic treatment	Procedure: Laparoscopic repair Simple suture with or without omental protective patch
Open repair Patients undergoing open treatment

Vigezo vya Kustahiki

Zama zinazostahiki Kujifunza	18 Years Kwa 18 Years
Jinsia Inastahiki Kujifunza	All
Njia ya sampuli	Non-Probability Sample
Hupokea Wajitolea wa Afya	Ndio
Vigezo	Inclusion Criteria: - Patients surgically treated for benign peptic ulcer perforation Exclusion Criteria: - Age < 18 years - Pregnant and breastfeeding women - Malignant ulcer perforation - Gastric resection - Diagnostic laparoscopy/laparotomy with no further surgical procedures performed

Matokeo

Hatua za Matokeo ya Msingi

1. 30-day Mortality Rate [18 months]

2. 30-day Morbidity Rate [18 months]

Morbidity defined by mean of the most used classification scoring system

Hatua za Matokeo ya Sekondari

1. Conversion rate [18 months]

Defined when a procedure was attempted via the minimally invasive approach but required an open incision to be completed

2. Calculation of Boey index [18 months]