Laparoscopic omental patch for perforated peptic ulcer disease reduces length of stay and complications, compared to open surgery: A SWSC multicenter study.
Am J Surg
; 218(6): 1060-1064, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31537324
ABSTRACT
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%, pâ¯<â¯0.05) as was unplanned re-operation (4.7% vs 14%, pâ¯<â¯0.05). Lap reduced LOS (6 vs 8 days, pâ¯<â¯0.001). Ileus was more in Lap (42% vs 18 pâ¯<â¯0.001) operative time was 14â¯min higher in Lap(pâ¯<â¯0.01) and admission to OR time was 4â¯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.
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Base de dados:
MEDLINE
Assunto principal:
Omento
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Úlcera Péptica Perfurada
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Complicações Pós-Operatórias
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Laparoscopia
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Tempo de Internação
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article