Laparoscopic omental patch for perforated peptic ulcer disease reduces length of stay and complications, compared to open surgery: A SWSC multicenter study - 21/11/19
Abstracts |
RCTs showed benefits in Lap repair of perforated peptic ulcer (PPU).
The SWSC Multi-Center Trials Group sought to evaluate whether Lap omental patch repairs compared to Open improved outcomes in PPU in general practice.
Data was collected from 9 SWSC Trial Group centers. Demographics, operative time, 30-day complications, length of stay and mortality were included.
461 patients |
Open in 311(67%) patients, Lap in 132(28%) with 20(5%) patients converted from Lap to Open. Groups were similar at baseline. Significant variability was found between centers in their utilization of Lap (0–67%).
Complications at 30 days were lower in Lap (18.5% vs. 27.5%, p < 0.05) as was unplanned re-operation (4.7% vs 14%, p < 0.05). Lap reduced LOS (6 vs 8 days, p < 0.001). Ileus was more in Lap (42% vs 18 p < 0.001) operative time was 14 min higher in Lap(p < 0.01) and admission to OR time was 4 h higher in Lap(<0.05). No significant difference readmission or mortality.
Our results suggest Lap should be considered a first-line option in suitable PPU patients requiring omental patch repair in centers that have the capacity and resources 24/7.
Le texte complet de cet article est disponible en PDF.Highlights |
• | In this multicenter study, there was wide variation in use of laparoscopy for perforated peptic ulcer from 0 – 67%. |
• | Patients undergoing laparoscopic repair had significantly shorter length of stay at 6 versus 8 days. |
• | Complications were lower in the laparoscopic group, at 18.5% versus 27.5%. |
• | There was no difference in readmission or mortality. |
Plan
Vol 218 - N° 6
P. 1060-1064 - décembre 2019 Retour au numéro
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