Surgical repair of perforated peptic ulcers: laparoscopic versus open approach

Vakayil, Victor; Bauman, Brent D.; Joppru, Keaton; Mallick, Reema; Tignanelli, Christopher J.; Connett, John E.; Ikramuddin, Sayeed; Harmon, James V.

doi:10.1007/s00464-018-6366-y

Cited by 24 publications

(42 citation statements)

References 63 publications

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“…Included studies were published between 1996 and 2019. Five were RCTs [14][15][16][17][18] , three were prospective cohort studies [19][20][21] , and the other 15 studies used retrospective cohort or case-control designs [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] ( Table 1). All compared outcomes of laparoscopic versus open peptic ulcer repair.…”

Section: Resultsmentioning

confidence: 99%

Variation in descriptors of patient characteristics in randomized clinical trials of peptic ulcer repair: a systematic review

Lee

Coe

O'Donoghue³

et al. 2020

British Journal of Surgery

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Background: The ability to compare findings across surgical research is important. Inadequate description of participants, interventions or outcomes could lead to bias and inaccurate assessment of findings. The aim of this study was to assess consistency of description of participants using studies comparing laparoscopic and open repair of peptic ulcer as an example. Methods: This systematic review is reported in line with the PRISMA checklist. Searches of MEDLINE and Embase databases were performed to identify studies comparing laparoscopic and open repair of perforated peptic ulcer in adults, published in the English language. Manuscripts were dual-screened for eligibility. Full texts were retrieved and dual-screened for inclusion. Data extracted from studies included descriptors of participants in studies from tables and text. Descriptors were categorized into conceptual domains by the research team, and coverage of each domain by study was tabulated. Results: Searches identified 2018 studies. After screening, 37 full texts were retrieved and 23 studies were included in the final synthesis. A total of 76 unique descriptors were identified. These were classified into demographics (11 descriptors), vital signs (9 descriptors), disease-specific characteristics (10 descriptors), presentation and pathway factors (4 descriptors), risk factors (8 descriptors), laboratory tests (14 descriptors) and baseline health (28 descriptors). The number of descriptors in a single study ranged from three to 31. All studies reported at least one demographic descriptor. Laboratory tests was the least frequently described domain. Conclusion: Study participants are described inconsistently in studies of a single example surgical condition.

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Section: Resultsmentioning

confidence: 99%

Variation in descriptors of patient characteristics in randomized clinical trials of peptic ulcer repair: a systematic review

Lee

Coe

O'Donoghue³

et al. 2020

British Journal of Surgery

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“…Its overall mortality rate is between 1.3% and 20%, whereas mortality due to perforation of the stomach ulcer is more than that of duodenal ulcer (40% vs 10%). 4 The omental patch is a common surgical answer to ulcerative perforation; however, 4 in some cases, omentum may not be available due to previous omental surgeries, inflammation, and adhesion caused by necrotic pulmonary peritonitis, or through penetration of the perforation site. 5 Furthermore, because of the postoperative ileus, stomach, and intestinal stretch, causing stretch at the omentum, postoperative suture leakage and opening can occur.…”

Section: Discussionmentioning

confidence: 99%

Novel approach for peptic ulcer perforation surgery

Ahmadinejad

Maghsoudi

2020

Clinical Case Reports

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“…We identified 4 SRs (2 older SRs were excluded 53,54 ), 2 RCTs, and 7 observational studies on laparoscopic repair of perforated peptic ulcers. [55][56][57][58][59][60][61][62][63][64][65] An SR (3 RCTs) found trends toward lower septic complications, SSI, ileus, and mortality with laparoscopy, and significantly shorter LOS in 1 RCT. 55,[66][67][68] An older SR (56 articles) found that laparoscopy is associated with decreased LOS, postoperative pain, and morbidity and mortality, but increased operating time and recurrent leak.…”

Section: Evidencementioning

confidence: 99%

“…57,58 Seven observational studies generally found shorter LOS and decreased morbidity and mortality. [59][60][61][62][63][64][65] We identified 2 SRs, 2 MAs, and 13 observational studies (5 studies were in the SRs and were therefore excluded [69][70][71] evaluating laparoscopic vs open emergent colon resections. [72][73][74][75][76][77][78][79][80][81][82][83] One MA (4 observational studies) on urgent or emergent sigmoidectomy for diverticulitis found that laparoscopy decreased complications (RR 0.62; 95% CI, 0.49 to 0.80; p ¼ 0.0002).…”

Section: Evidencementioning

confidence: 99%

Technical Evidence Review for Emergency Major Abdominal Operation Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

Grant

Hornor

et al. 2020

Journal of the American College of Surgeons

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Enhanced recovery pathways (ERPs), initially developed more than 2 decades ago for colorectal operations, have been shown to improve patient outcomes for many elective procedures. 1-4 They apply standardized, evidencebased, and multidisciplinary approaches to reduce surgical stress and modify physiologic responses. 5-9 As these pathways evolve, it is evident that the key principles, including multimodal analgesia, early mobilization, patient and family engagement, and best practices for preventable harms, can benefit surgical patients broadly, including those undergoing emergency operations. Emergency general surgery (EGS) represents a growing public health burden in the US, with more than 3 million patients admitted annually for these conditions and nearly 30% requiring operation. 10 EGS patients are complex; 35% are older than 70 years and 50% have at least 1 medical comorbidity and are at higher risk for morbidity (15%) and mortality (1.2%). 10,11 Rates are even higher for complex emergency procedures, including 46.9% morbidity for bowel resections and 23.8% mortality for laparotomies. 11 Quality improvement work in EGS is challenging, limited by the urgent nature and heterogeneity in disease and patient characteristics. However, given that the success of ERPs lies in reducing perioperative stress through transdisciplinary teamwork and standardization, the benefits of ERPs might be even more pronounced in this high-risk population. The Safety Program for Improving Surgical Care and Recovery (ISCR) is a national ERP initiative implemented in 2017 through a collaboration among AHRQ (funder), American College of Surgeons, and Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. The ISCR program has been implemented across colorectal, orthopaedic, and gynecologic surgery services. Building on the lessons learned from earlier cohorts, the final cohort of the program will expand into EGS and include appendectomy; cholecystectomy; and emergency, nontrauma, and nonvascular major abdominal operations. The objective of this study was to evaluate the evidence for ERPs for emergency major abdominal operations and to provide a framework for developing and implementing ERPs in this patient population. METHODS Seven common EGS procedures, including appendectomy, cholecystectomy, perforated peptic ulcer repair, colectomy, CME questions for this article available at http://jacscme.facs.org

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Surgical repair of perforated peptic ulcers: laparoscopic versus open approach

Cited by 24 publications

References 63 publications

Variation in descriptors of patient characteristics in randomized clinical trials of peptic ulcer repair: a systematic review

Variation in descriptors of patient characteristics in randomized clinical trials of peptic ulcer repair: a systematic review

Novel approach for peptic ulcer perforation surgery

Technical Evidence Review for Emergency Major Abdominal Operation Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

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