Modern aspects of the complex treatment of perforated gastric and duodenal ulcer

Tarasenko, S. V.; Natalsky, A A; Panin, S I; Сажин, И В; Yudin, V. A.; Sazhin, V P; Peskov, O D; Bogomolov, A Yu

doi:10.17116/hirurgia202101142

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…O tratamento médico em curso foi registrado em uma proporção significativa de pacientes, incluindo aspirina em 26 pacientes (23%), AINES em 23 (20%) e esteróides sistêmicos em 9 (8%). Atualmente, o tratamento para úlcera gástrica e duodenal perfurada consiste na terapia combinada entre o tratamento cirúrgico e medicações, como inibidores da bomba de prótons e antibacterianos (TARASENKO et al, 2021).…”

Section: Revisão De Literaturaunclassified

Laparoscopia versus laparotomia na Úlcera Péptica Perfurada: revisão de literatura dos últimos cinco anos

Mota¹,

Oliveira²,

Squeff³

et al. 2023

Braz. J. Hea. Rev.

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A úlcera péptica é uma enfermidade que afeta milhões de pessoas. Apesar dos avanços quanto ao entendimento e tratamento da doença, o número de pacientes diagnosticados com perfuração de úlcera péptica não vem diminuindo. Concomitantemente, a taxa de mortalidade supera outras situações de emergência comuns. O padrão-referência para perfurações simples é o reparo laparoscópico, porém grandes ulcerações perfuradas, a laparotomia com piloroplastia pode se tornar a melhor escolha. O presente trabalho tem como objetivo fornecer uma síntese das evidências atuais acerca dos aspectos biológicos e clínicos envolvidos nas técnicas laparoscópicas e laparotômicas para correção de úlcera péptica perfurada. A coleta de dados ocorreu por meio de busca bibliográfica na base de dados PubMed (via National Library of Medicine), utilizando os descritores “Peptic ulcer”, “Laparoscopic”, “Laparoscopy”, “Laparotomy”. Foram selecionados 56 trabalhos publicados entre 2017 e 2022. Considerando que há diferentes técnicas cirúrgicas para correção de úlcera peptídica perfurada, a revisão traz a definição correta de tal condição, bem como com a abordagem de cada técnica, envolvendo aspectos inerentes às indicações e contraindicações, complicações trans e pós-operatórias, tempo de internação, tempo de cirurgia, custo financeiro e taxa de mortalidade. Os resultados do presente estudo podem ajudar a desenvolver estratégias eficientes e seguras para a prevenção e o tratamento dessa condição, além de contribuir para uma conduta adequada durante a terapia dos indivíduos.

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Section: Revisão De Literaturaunclassified

Laparoscopia versus laparotomia na Úlcera Péptica Perfurada: revisão de literatura dos últimos cinco anos

Mota¹,

Oliveira²,

Squeff³

et al. 2023

Braz. J. Hea. Rev.

View full text Add to dashboard Cite

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“…Partial resection, selective, and non-selective vagotomy methods applied in the past were limited to resistant cases. [4] In cases of duodenal ulcer perforation, it is seen that the omentum, also called the abdominal policeman, is in the perforation area and usually closes the perforation hole with the omental plug. Actually, the perforation is repaired by the omentum.…”

Section: Introductionmentioning

confidence: 99%

“…Partial resection, selective, and non-selective vagotomy methods applied in the past were limited to resistant cases. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of “primary repair” and “placing a drain without repair” methods in duodenum perforations

Karatas

Kanlıöz²,

Gokturk

et al. 2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:Duodenal ulcer perforation is a serious condition. A number of methods have been defined and used in surgical treatment. In this study, it was aimed to compare the effectiveness of "primary repair" and "drain placement without repair" methods in duodenal perforations using an animal model. METHODS:Three equivalent groups of ten rats each were formed. Perforation was created in the duodenum in the first (primary repair/sutured group) and the second group (drain placement without repair/sutureless drainage group). In the first group, the perforation was repaired with sutures. In the second group, only a drain was placed in the abdomen without sutures. In the third group (control group), only laparotomy was performed. Neutrophil count, sedimentation, serum C-reactive protein (CRP), serum total antioxidant capacity (TAC), serum total thiol, serum native thiol, and serum myeloperoxidase (MPO) analyses were performed on animal subjects in the pre-operative period and on the post-operative 1 st and 7 th days. Histological and immunohistochemical (transforming growth factor-beta 1 [TGF-β1]) analyzes were performed. Blood analysis, histological, and immunohistochemical findings obtained from the groups were compared statistically. RESULTS:There was no significant difference between the first and second groups, except for the TAC on the post-operative 7 th day and MPO values on the post-operative 1 st day (P>0.05). Although tissue healing was more pronounced in the second group than in the first group, there was no significant difference between the groups (P>0.05). TGF-β1 immunoreactivity observed in the second group was found to be significantly higher than in the first group (P<0.05). CONCLUSION:We think that the sutureless drainage method is as effective as the primary repair method in the treatment of duodenal ulcer perforation and can be safely applied as an alternative to the primary repair method. However, further studies are needed to fully determine the efficacy of the sutureless drainage method.

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“…Some authors adhere to strict selection of patients with perforated duodenal ulcer for laparos-2395 copy and use it for low-risk patients. Others adhere to a "laparoscopy-first" policy in the treatment of perforated peptic ulcer [ 7 ] .…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study between Open and Laparoscopic Omental Patch Repair of Perforated Duodenal Ulcer

HASSAN¹,

MAKSOUD

2022

The Medical Journal of Cairo University

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Background: Perforation is a life-threatening complication of duodenal ulcer (DU), it requires immediate surgical intervention in most cases. Perforation occurs in 2-10% of cases of DU with a high risk of mortality, especially among the elderly. Simple closure of the perforation with an omental patch is a technically easy, reliable and preferable method. However, many authors consider laparoscopic repair of perforated duodenal ulcer be superior to conventional open repair in terms of reduced pain, shorter hospital stay, better cosmetics and wound healing. Aim of Study: The present work aimed to elucidate the differences between open and laparoscopic repair of PDU, regarding operation time and postoperative outcome. Patients and Methods: The present cohort observational study, with a sample size of 40 patients, compared open omental patch repair, and laparoscopic repair of PDU, regarding operative time and post-operative outcome. Results: Statistical analysis of the collected data, using one way ANOVA test, elaborated a significantly reduced operative time in laparoscopy group versus open repair group. Moreover, Laparoscopy group showed less incidence of postoperative ileus, leakage and ICU admission, compared to open repair group. Open repair group showed less incidence of postoperative ARDS, laparoscopic repair elucidated a significantly less time taken for mobilization of the patients postoperatively, and reduced mean hospital stay, versus open group.

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Modern aspects of the complex treatment of perforated gastric and duodenal ulcer

Cited by 6 publications

References 7 publications

Laparoscopia versus laparotomia na Úlcera Péptica Perfurada: revisão de literatura dos últimos cinco anos

Laparoscopia versus laparotomia na Úlcera Péptica Perfurada: revisão de literatura dos últimos cinco anos

Comparison of “primary repair” and “placing a drain without repair” methods in duodenum perforations

A Comparative Study between Open and Laparoscopic Omental Patch Repair of Perforated Duodenal Ulcer

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