Flore Vărcuş1, Mircea Beuran2, Ioan Lica2, Claudiu Turculet2, Adrian Valentin Cotarlet3, Stefan Georgescu4, Dan Vintila4, Dan Sabău5, Alexandru Sabau6, Constantin Ciuce7, Vasile Bintintan7, Eugen Georgescu8, Razvan Popescu9, Cristi Tarta10, Valeriu Surlin8. 1. Surgical Clinic 2, Clinical Emergency County Hospital, Victor Babes University of Medicine and Pharmacy, Str. I. Bulbuca, No. 10, Timisoara, Romania. varcus.florian@yahoo.com. 2. Surgical Clinic 2, Clinical Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 3. Onesti City Hospital, Onesti, Romania. 4. Surgical Clinic 2, County Emergency Hospital "Sf. Spiridon", Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania. 5. Surgical Clinic 2, Emergency County Hospital, Victor Papilian Faculty of Medicine, Sibiu, Romania. 6. Surgical Clinic 2, Victor Papilian Faculty of Medicine, Sibiu, Romania. 7. Surgical Clinic 1, Emergency County Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. 8. Surgical Clinic 1, County Emergency Hospital, University of Medicine and Pharmacy Craiova, Craiova, Romania. 9. Surgical Clinic 2, Emergency County Hospital, Faculty of Medicine, Ovidius University, Constanţa, Romania. 10. Surgical Clinic 2, Clinical Emergency County Hospital, Victor Babes University of Medicine and Pharmacy, Str. I. Bulbuca, No. 10, Timisoara, Romania.
Abstract
BACKGROUNDS: The incidence of patients presenting with perforated peptic ulcers (PPU) has decreased during the last decades. At the same time, a laparoscopic approach to this condition has been adopted by increased number of surgeons. The aim of this study was to evaluate the early postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in eight Romanian surgical centers with extensive experience in laparoscopic surgery. METHODS: Between 2009 and 2013, 297 patients with perforated peptic ulcer were operated in the eight centers participating in this retrospective study. The patients' charts were reviewed for demographics, surgical procedure, complications and short-term outcomes. RESULTS: Boey score of 0 was found in 122 patients (41.1%), Boey 1 in 169 (56.9%), Boey 3 in 6 (2.0%). For 145 (48.8%) patients, primary suture repair was performed, in 146 (49.2%) primary suture repair with omentopexy. There were 6 (2.0%) conversions to open surgery. The operative time was between 25 and 120 min, with a mean of 68 min. Two (0.7%) deaths were noted. Mean hospital stay was 5.5 days, ranges 3-25 days. Postoperative complications included: 7 (2.4%) superficial surgical site infections, 5 (1.6%) cardiovascular, 3 (1.0%) pulmonary, 2 (0.7%) duodenal leakages, 3 (1.0%) deep space infections and 1 (0.3%) upper digestive hemorrhage. CONCLUSIONS: This study shows that the laparoscopic approach for PPU is feasible; the procedure is safe, with no increased risk of duodenal fistulae or residual intraperitoneal abscesses. We now consider the laparoscopic approach for PPU as the "gold standard" in patients with Boey score 0 or 1.
BACKGROUNDS: The incidence of patients presenting with perforated peptic ulcers (PPU) has decreased during the last decades. At the same time, a laparoscopic approach to this condition has been adopted by increased number of surgeons. The aim of this study was to evaluate the early postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in eight Romanian surgical centers with extensive experience in laparoscopic surgery. METHODS: Between 2009 and 2013, 297 patients with perforated peptic ulcer were operated in the eight centers participating in this retrospective study. The patients' charts were reviewed for demographics, surgical procedure, complications and short-term outcomes. RESULTS: Boey score of 0 was found in 122 patients (41.1%), Boey 1 in 169 (56.9%), Boey 3 in 6 (2.0%). For 145 (48.8%) patients, primary suture repair was performed, in 146 (49.2%) primary suture repair with omentopexy. There were 6 (2.0%) conversions to open surgery. The operative time was between 25 and 120 min, with a mean of 68 min. Two (0.7%) deaths were noted. Mean hospital stay was 5.5 days, ranges 3-25 days. Postoperative complications included: 7 (2.4%) superficial surgical site infections, 5 (1.6%) cardiovascular, 3 (1.0%) pulmonary, 2 (0.7%) duodenal leakages, 3 (1.0%) deep space infections and 1 (0.3%) upper digestive hemorrhage. CONCLUSIONS: This study shows that the laparoscopic approach for PPU is feasible; the procedure is safe, with no increased risk of duodenal fistulae or residual intraperitoneal abscesses. We now consider the laparoscopic approach for PPU as the "gold standard" in patients with Boey score 0 or 1.
Authors: Wing T Siu; Heng T Leong; Bonita K B Law; Chun H Chau; Anthony C N Li; Kai H Fung; Yuk P Tai; Michael K W Li Journal: Ann Surg Date: 2002-03 Impact factor: 12.969
Authors: Tamer Saafan; Walid El Ansari; Omer Al-Yahri; Ammar Eleter; Hisham Eljohary; Rashad Alfkey; Mustafa Hajjar; Ali Toffaha; Abdelrahman El Osta Journal: Ann Med Surg (Lond) Date: 2019-05-10
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