BACKGROUND: Because the feasibility and safety of laparoscopic approaches for the treatment of perforated peptic ulcer (PPU) have been fully recognized, laparoscopic repair of PPU (LPPU) has become a widely accepted procedure. Following closure of a PPU, the rationale to add an omental patch is based on the assumptions that a patch may decrease the possibility of leakage and make the closure more secure. However, one of the often mentioned disadvantages of LPPU is that it requires a significantly longer operating time. The purpose of the present study was to evaluate the efficacy of LPPU with a sutureless onlay omental patch. METHODS: Over 60 months, 43 patients underwent LPPU with sutureless onlay omental patch, and another 64 patients underwent LPPU with sutured omental patch. Patient demographics, operation parameters, and surgical outcomes were analyzed retrospectively. RESULTS: All patients in both groups survived to the end of the study. There were no leaks in either group. The operating time and length of stay in the sutureless onlay omental patch group were significantly shorter than in the sutured omental patch group. CONCLUSIONS: A sutureless onlay omental patch is as safe and effective as a sutured omental patch for the laparoscopic repair of PPU.
BACKGROUND: Because the feasibility and safety of laparoscopic approaches for the treatment of perforated peptic ulcer (PPU) have been fully recognized, laparoscopic repair of PPU (LPPU) has become a widely accepted procedure. Following closure of a PPU, the rationale to add an omental patch is based on the assumptions that a patch may decrease the possibility of leakage and make the closure more secure. However, one of the often mentioned disadvantages of LPPU is that it requires a significantly longer operating time. The purpose of the present study was to evaluate the efficacy of LPPU with a sutureless onlay omental patch. METHODS: Over 60 months, 43 patients underwent LPPU with sutureless onlay omental patch, and another 64 patients underwent LPPU with sutured omental patch. Patient demographics, operation parameters, and surgical outcomes were analyzed retrospectively. RESULTS: All patients in both groups survived to the end of the study. There were no leaks in either group. The operating time and length of stay in the sutureless onlay omental patch group were significantly shorter than in the sutured omental patch group. CONCLUSIONS: A sutureless onlay omental patch is as safe and effective as a sutured omental patch for the laparoscopic repair of PPU.
Authors: Antonio Tarasconi; Federico Coccolini; Walter L Biffl; Matteo Tomasoni; Luca Ansaloni; Edoardo Picetti; Sarah Molfino; Vishal Shelat; Stefania Cimbanassi; Dieter G Weber; Fikri M Abu-Zidan; Fabio C Campanile; Salomone Di Saverio; Gian Luca Baiocchi; Claudio Casella; Michael D Kelly; Andrew W Kirkpatrick; Ari Leppaniemi; Ernest E Moore; Andrew Peitzman; Gustavo Pereira Fraga; Marco Ceresoli; Ronald V Maier; Imtaz Wani; Vittoria Pattonieri; Gennaro Perrone; George Velmahos; Michael Sugrue; Massimo Sartelli; Yoram Kluger; Fausto Catena Journal: World J Emerg Surg Date: 2020-01-07 Impact factor: 5.469