“…Because laparoscopic incisions are so small, the wound infection rate is lower in the laparoscopic group. Comparable results were seen in the Lunevicius et al study [17][18] . In comparison to Golash et al study, the mean time needed to return to regular activities in the open group was 33 days and in the laparoscopic group was 14 days which showed that the open group required more time to resume normal work 19 .…”
Background: The surgical treatment of perforated duodenal ulcers is not controversial; however, the best surgical strategy is still up for debate. The perforation closure with an omental patch or without it during surgery is the basis of perforated duodenal ulcers treatment. Laparoscopic surgery can now be used to repair a perforated duodenal ulcer due to developments in minimal access surgery. Aim: In this analysis, the results of open versus laparoscopic repair of perforated duodenal ulcers were compared in terms of operating time, length of hospital stays, postoperative pain and complications after the operation, among other factors. Methods: This prospective comparative study was held at the surgical department of Agha Khan University Hospital, Karachi for one-year duration from January 2022 to December 2022. Patients were divided randomly into two groups, A and B, who underwent operations using laparoscopic and conventional methods, correspondingly, and results were compared. Results: This study found that men between the ages of 51 and 60 were most frequently affected. Laparoscopic group patients experienced much less post-operative pain, need less analgesics, minimum wound infection, and less stay in hospital than open group patients (p 0.05). Conclusions: Laparoscopic repair when performed on carefully chosen patients for perforated duodenal ulcers, it is safe, practical, and produces better outcomes than open surgery. Keywords: Omental patch, laparoscopic repair, open repair, perforated duodenal ulcer
“…Because laparoscopic incisions are so small, the wound infection rate is lower in the laparoscopic group. Comparable results were seen in the Lunevicius et al study [17][18] . In comparison to Golash et al study, the mean time needed to return to regular activities in the open group was 33 days and in the laparoscopic group was 14 days which showed that the open group required more time to resume normal work 19 .…”
Background: The surgical treatment of perforated duodenal ulcers is not controversial; however, the best surgical strategy is still up for debate. The perforation closure with an omental patch or without it during surgery is the basis of perforated duodenal ulcers treatment. Laparoscopic surgery can now be used to repair a perforated duodenal ulcer due to developments in minimal access surgery. Aim: In this analysis, the results of open versus laparoscopic repair of perforated duodenal ulcers were compared in terms of operating time, length of hospital stays, postoperative pain and complications after the operation, among other factors. Methods: This prospective comparative study was held at the surgical department of Agha Khan University Hospital, Karachi for one-year duration from January 2022 to December 2022. Patients were divided randomly into two groups, A and B, who underwent operations using laparoscopic and conventional methods, correspondingly, and results were compared. Results: This study found that men between the ages of 51 and 60 were most frequently affected. Laparoscopic group patients experienced much less post-operative pain, need less analgesics, minimum wound infection, and less stay in hospital than open group patients (p 0.05). Conclusions: Laparoscopic repair when performed on carefully chosen patients for perforated duodenal ulcers, it is safe, practical, and produces better outcomes than open surgery. Keywords: Omental patch, laparoscopic repair, open repair, perforated duodenal ulcer
“…(Table 2). Regarding risk of bias assessment, one study 14 was judged to have high risk, while the rest 3 studies 15-17 was considered moderate risk of bias. (Table 3)Figure 2.Forest plots of primary and secondary outcomes.…”
Aims To evaluate comparative outcomes of laparoscopic repair of perforated peptic ulcer with omental patch versus without omental patch. Methods A systematic search of multiple electronic data sources was conducted, and all studies comparing laparoscopic repair of perforated peptic ulcer (PPU) with and without omental patch were included. Operative time, postoperative complications, re-operation and mortality were the evaluated outcome parameters for the meta-analysis. Revman 5.3 was used for data analysis. Results Four observational studies reporting a total number of 438 patients who underwent laparoscopic repair of PPU with (n = 268) or without (n = 170) omental patch were included. Operative time was significantly shorter in no-omental patch group (NOP) when compared to omental patch group ( P = .02). There was no significant difference in the risk of postoperative ileus (Odd ratio (OR) .76, P = .61), leakage (OR 1.17, P = .80), wound infection (OR 1.89, P = .34), intra-abdominal abscess (OR 1.17, P = .87), re-operation (OR .00, P = .94) and mortality (OR .55, P = .48). Moreover, length of hospital stay was comparable between the two groups ( P = .81). Conclusion Laparoscopic repair of PPU with or without omental patch have comparable postoperative complications and mortality rate. However, considering the shorter operative time, no-omental patch approach is an attractive and more favourable choice. Well-designed randomized controlled trials are needed to investigate this comparison.
“…No que se refere ao tempo operatório, quando realizada laparoscopia com e sem correção omental, foi menor no grupo sem correção (MOHAMEDAHMED et al, 2022). Esse achado valida um estudo de Pan et al (2020), com pacientes submetidos a fechamento simples sem correção omental (grupo A) e fechamento simples com correção omental (grupo B), com tempo de operação médio de 84,4 minutos para o grupo A e 106,65 minutos no grupo B. Um maior tempo operatório também foi observado em casos de reparo de Cellan-Jones modificado por laparoscopia, comparados a laparoscopia (ODISHO et al, 2022).…”
Section: Tempo De Cirurgiaunclassified
“…Já em casos de laparoscopia com e sem correção omental, o tempo de internação é semelhante em ambos os grupos (PAN et al, 2020;MOHAMEDAHMED et al, 2022).…”
Section: Tempo De Internaçãounclassified
“…O uso da laparoscopia é apresentado como um motivo independe relacionado às reduções de mortalidade, apesar de ser em um grupo de pacientes jovens e saudáveis (JOHNSON et al, 2019). Ao comparar pacientes de laparoscopia com correção omental com laparoscopia sem correção omental, nenhuma diferença na taxa de mortalidade foi encontrada (PAN et al, 2020;MOHAMEDAHMED et al, 2022).…”
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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