1
|
Peng Y, Xiong S, Ding Y, Xie L, Wang Y, Mei Y, Liu W, Deng T. The effect of omentoplasty in various surgical operations: systematic review and meta-analysis. Int J Surg 2024; 110:3778-3794. [PMID: 38446845 PMCID: PMC11175753 DOI: 10.1097/js9.0000000000001240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Omentoplasty is commonly used in various surgeries. However, its effectiveness is unsure due to lack of convincing data and research. To clarify the impact of omentoplasty on postoperative complications of various procedures, this systematic review and meta-analysis was performed. METHODS A systematic review of published literatures from four databases: PubMed, Web of Science, Cochrane Library, and Embase before 14 July 2022. The authors primarily included publications on five major surgical operations performed in conjunction with omentoplasty: thoracic surgery, esophageal surgery, gastrointestinal surgery, pelvi-perineal surgery, and liver surgery. The protocol was registered in PROSPERO. RESULTS This review included 25 273 patients from 91 studies ( n =9670 underwent omentoplasty). Omentoplasty was associated with a lower risk of overall complications particularly in gastrointestinal [relative risk (RR) 0.53; 95% CI: 0.39-0.72] and liver surgery (RR 0.54; 95% CI: 0.39-0.74). Omentoplasty reduced the risk of postoperative infection in thoracic (RR 0.38; 95% CI: 0.18-0.78) and liver surgery (RR 0.39; 95% CI: 0.29-0.52). In patients undergoing esophageal (RR 0.89; 95% CI: 0.80-0.99) and gastrointestinal (RR 0.28; 95% CI: 0.23-0.34) surgery with a BMI greater than 25, omentoplasty is significantly associated with a reduced risk of overall complications compared to patients with normal BMI. No significant differences were found in pelvi-perineal surgery, except infection in patients whose BMI ranged from 25 kg/m 2 to 29.9 kg/m 2 (RR 1.25; 95% CI: 1.04-1.50) and anastomotic leakage in patients aged over 60 (RR 0.59; 95% CI: 0.39-0.91). CONCLUSION Omentoplasty can effectively prevent postoperative infection. It is associated with a lower incidence of multiple postoperative complications in gastrointestinal and liver surgery.
Collapse
Affiliation(s)
- Yaqi Peng
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology
- Key Laboratory of Diabetes Immunology, Ministry of Education, Metabolic Syndrome Research Center
| | - Shan Xiong
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology
- Key Laboratory of Diabetes Immunology, Ministry of Education, Metabolic Syndrome Research Center
| | - Yujin Ding
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology
- Key Laboratory of Diabetes Immunology, Ministry of Education, Metabolic Syndrome Research Center
| | - Limin Xie
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology
- Key Laboratory of Diabetes Immunology, Ministry of Education, Metabolic Syndrome Research Center
| | - Yihang Wang
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology
- Key Laboratory of Diabetes Immunology, Ministry of Education, Metabolic Syndrome Research Center
| | - Ying Mei
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology
- Key Laboratory of Diabetes Immunology, Ministry of Education, Metabolic Syndrome Research Center
| | - Wei Liu
- Department of Biliopancreatic Surgery and Bariatric Surgery
| | - Tuo Deng
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology
- Key Laboratory of Diabetes Immunology, Ministry of Education, Metabolic Syndrome Research Center
- Clinical Immunology Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
| |
Collapse
|
2
|
Li ZW, Tong Y, Liu F, Liu XR, Lv Q, Tang KL, Li LS, Liu XY, Zhang W, Peng D. A comparative study on laparoscopic and open surgical approaches for perforated peptic ulcer repair: efficacy and outcomes analysis. Langenbecks Arch Surg 2023; 408:435. [PMID: 37964034 DOI: 10.1007/s00423-023-03171-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE This study aimed to compare the clinical outcomes of the clinical outcomes of laparoscopic and open sutures for peptic ulcer perforation (PPU). MATERIALS AND METHODS PubMed, EMBASE, and Cochrane Library databases were searched for eligible studies from inception to March 31, 2023. Odds ratios (OR) and 95% confidence intervals (Cl) were also calculated. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included studies. This study was performed using the Stata (V.16.0) software. RESULTS A total of 29 studies involving 17,228 patients were included in this study. In terms of postoperative outcomes, the laparoscopic group had a shorter postoperative hospital stay (MD = -0.29, 95%CI = -0.44 to -0.13, P = 0.00), less blood loss (MD = -0.45, 95%CI = -0.82 to -0.08, P = 0.02), fewer wound infection (OR = 0.20, 95%CI = 0.17 to 0.24, P = 0.00), fewer pneumonia (OR = 0.59, 95%CI = 0.41 to 0.87, P = 0.01), fewer respiratory complications (OR = 0.26, 95%CI = 0.13 to 0.55, P = 0.00) and lower postoperative morbidity (OR = 0.51, 95%CI = 0.33 to 0.78, P = 0.00). The laparoscopic group had a lower mortality rate (OR = 0.36, 95%CI = 0.27 to 0.49, P = 0.00) than the open group. We also found that the laparoscopic group had a higher overall complication rate than the open group (OR = 0.45, 95%CI = 0.34 to 0.60, P = 0.00). CONCLUSION Laparoscopic repair was associated with a lower risk of mortality than open repair in patients with PPU. Laparoscopic repair may be a better option in patients with PPU.
Collapse
Affiliation(s)
- Zi-Wei Li
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yue Tong
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Fei Liu
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xu-Rui Liu
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Quan Lv
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Kai-Lin Tang
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Lian-Shuo Li
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiao-Yu Liu
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wei Zhang
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Dong Peng
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
| |
Collapse
|
3
|
Kim HS, Kim HI, Yoon YJ, Yeom JH, Kim MG. Analysis of prognostic factors for postoperative complications and mortality in elderly patients undergoing emergency surgery for intestinal perforation or irreversible intestinal ischemia. Ann Surg Treat Res 2023; 105:198-206. [PMID: 37908381 PMCID: PMC10613825 DOI: 10.4174/astr.2023.105.4.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 11/02/2023] Open
Abstract
Purpose Because the global geriatric population continues to increase, the assessment of emergency surgical outcomes in elderly patients with acute peritonitis will become more important. Methods A retrospective review was conducted on the data of 174 elderly patients who underwent emergency surgery for intestinal perforation or intestinal infarction between June 2010 and November 2022. We conducted an analysis of the risk factors associated with postoperative complications and mortality by evaluating the characteristics of patients and their surgical outcomes. Results In our study, most patients (94.3%) had preexisting comorbidities, and many patients (84.5%) required transfer to the intensive care unit following emergency surgery. Postoperative complications were observed in 84 individuals (48.3%), with postoperative mortality occurring in 29 (16.7%). Multivariate analysis revealed preoperative acute renal injury, hypoalbuminemia, and postoperative ventilator support as significant predictors of postoperative mortality. Conclusion When elderly patients undergo emergency surgery for intestinal perforation or infarction, it is important to recognize that those with preoperative acute renal injury, hypoalbuminemia, and a need for postoperative ventilator support have a poor prognosis. Therefore, these patients require intensive care from the early stages of treatment.
Collapse
Affiliation(s)
- Hyung Suk Kim
- Department of Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Seoul, Korea
| | - Hyun Il Kim
- Department of Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Seoul, Korea
| | - Young Joon Yoon
- Department of Anesthesiology, Hanyang University Guri Hospital, Hanyang University School of Medicine, Seoul, Korea
| | - Jong Hoon Yeom
- Department of Anesthesiology, Hanyang University Guri Hospital, Hanyang University School of Medicine, Seoul, Korea
| | - Min Gyu Kim
- Department of Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Seoul, Korea
| |
Collapse
|
4
|
Kim HI, Cho YJ, Yeom JH, Jeon WJ, Kim MG. Perforation on the superior side of duodenum is a risk factor of laparoscopic primary repair for duodenal ulcer perforation. Ann Surg Treat Res 2021; 100:228-234. [PMID: 33854992 PMCID: PMC8019982 DOI: 10.4174/astr.2021.100.4.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/29/2020] [Accepted: 01/12/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Primary repair is the standard surgical method for treating duodenal ulcer perforations, with very good results usually anticipated because of the simplicity of the associated surgical techniques. Therefore, this study aimed to analyze the risk factors that affect laparoscopic primary repair outcomes for duodenal ulcer perforation. Methods Between June 2010 and June 2020, 124 patients who underwent laparoscopic primary repair for duodenal ulcer perforations were reviewed. Early surgical outcomes were evaluated and risk factors for postoperative complications were assessed. Results All surgeries were performed laparoscopically without open conversion. Multivariate analysis showed that the elderly (over 70 years), and perforations that needed more than 2 stitches for closure were risk factors for overall postoperative complications. Perforations that needed more than 2 stitches and perforations on the superior side of the duodenum were major risk factors for severe postoperative complications. Severe postoperative complications occurred in 6 of the patients, and 1 of them died of multiorgan failure. Conclusion Based on our results, we suggest that laparoscopic primary repair can be safely performed in duodenal ulcer perforation. However, more careful surgery and postoperative care are needed to improve the surgical outcomes of patients who need more than 2 stitches to close their perforation or who have perforations on the superior side of the duodenum.
Collapse
Affiliation(s)
- Hyun Il Kim
- Department of Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri, Korea
| | - Yu Jeong Cho
- Department of Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri, Korea
| | - Jong Hoon Yeom
- Department of Anesthesiology, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri, Korea
| | - Woo Jae Jeon
- Department of Anesthesiology, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri, Korea
| | - Min Gyu Kim
- Department of Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri, Korea
| |
Collapse
|
5
|
Kim HS, Lee JH, Kim MG. Outcomes of laparoscopic primary gastrectomy with curative intent for gastric perforation: experience from a single surgeon. Surg Endosc 2020; 35:4206-4213. [PMID: 32860136 DOI: 10.1007/s00464-020-07902-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/17/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Gastric cancer perforation is rare and difficult to distinguish from gastric ulcer perforation before surgery. Peritonitis caused by gastric perforation requires emergency surgery. The optimal surgical strategy for gastric perforation has not been established. MATERIAL AND METHODS Data from 43 patients who underwent primary gastrectomy with curative intent for gastric perforation between June 2010 and November 2019 were reviewed. Patients were classified into gastric ulcer and gastric cancer groups. Early surgical outcomes and overall survival were assessed. RESULTS There were no significant differences in clinical characteristics between the two groups except regarding preoperative shock. Laparoscopic gastrectomy was performed in 35 of 43 patients. There were no conversions to open surgery. The surgical findings demonstrated that the gastric cancer group had larger mass lesions with significantly larger perforations than did the gastric ulcer group. There were no significant differences in early surgical outcomes. Severe postoperative complications occurred in nine patients, five of whom died within one month of surgery. The majority of patients (90%) had stage III or IV gastric cancer. The 5-year survival rate was 19.5%. CONCLUSION We found no definitive differences in clinical characteristics distinguishing gastric cancer from ulcers. Considering our surgical outcomes, laparoscopic primary gastrectomy performed by an expert is a useful technique for emergency gastric perforation. However, unless an expert is available, caution should be used when selecting laparoscopic primary gastrectomy with curative intent as a surgical method.
Collapse
Affiliation(s)
- Hyung Suk Kim
- Department of Surgery, Hanyang University Guri Hospital, 153, Gyeongchun-ro, Guri, 471-701, Korea
| | - Jun Ho Lee
- Department of Surgery, Hanyang University Guri Hospital, 153, Gyeongchun-ro, Guri, 471-701, Korea
| | - Min Gyu Kim
- Department of Surgery, Hanyang University Guri Hospital, 153, Gyeongchun-ro, Guri, 471-701, Korea. .,Department of Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Seoul, Korea.
| |
Collapse
|
6
|
Nguyen TH, Dang TN, Schnelldorfer T. Single-Port Laparoscopic Repair of Perforated Duodenal Ulcers. World J Surg 2020; 44:1425-1430. [PMID: 31897688 DOI: 10.1007/s00268-019-05352-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Laparoscopic single-port surgery has widely been introduced for the treatment of various abdominal conditions. But controversies still exist regarding its potential advantages and risks, especially for emergency surgery. The aim of this study was to evaluate the results of a single-port laparoscopic repair using straight laparoscopic instruments for the treatment of perforated duodenal ulcers. METHODS A prospective consecutive case series was conducted including all patients with a perforated duodenal ulcer who underwent a laparoscopic single-port repair at a single institution from January 2012 to June 2018. The operation was performed through a single port using conventional straight laparoscopic instruments and intra-corporeal knot tying techniques. RESULTS Out of 75 patients, simple closure of the perforation without omental patch was accomplished in 96% of cases. Conversion to an open operation was required in one patient (1.3%) due to a posterior duodenal perforation, and additional trocar placement was needed in another patient (1.3%). The mean incision length was 2.0 ± 0.2 cm. The mean operation time was 63.0 ± 26.6 min. Meantime a nasogastric tube remained in place was 2.9 ± 0.8 days. Mean duration of analgesic use was 2.8 ± 0.8 days. The rate of postoperative complications was 2.7%, including two patients with wound infections. There were no instances of intestinal leak or abscess. The postoperative hospital stay was 5.7 ± 1.2 days. CONCLUSION Laparoscopic single-port repair using conventional straight laparoscopic instruments with intra-corporeal knot tying technique was safe and feasible for patients with perforated duodenal ulcers with low risk factors. This method offers results comparable to those expected with the standard multiport laparoscopic approach with the addition of improved cosmetic outcomes.
Collapse
Affiliation(s)
- Tri Huu Nguyen
- Department of Digestive Surgery, Hue University School of Medicine and Pharmacy, Hue City, Vietnam.
| | - Thanh Nhu Dang
- Department of Digestive Surgery, Hue University School of Medicine and Pharmacy, Hue City, Vietnam
| | - Thomas Schnelldorfer
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA.,Department of Biomedical Engineering, Tufts University, Medford, MA, USA
| |
Collapse
|
7
|
Extending the Indication for Laparoscopic Surgery in Patients With Pan-Peritonitis. Surg Laparosc Endosc Percutan Tech 2019; 29:120-125. [PMID: 30531448 DOI: 10.1097/sle.0000000000000613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND There have been reports of favorable results in patients with peritonitis who underwent laparoscopic surgery. The present study evaluated the outcomes of laparoscopic surgery in patients with pan-peritonitis. MATERIALS AND METHODS We enrolled 148 patients who underwent open and laparoscopic surgery for pan-peritonitis between January 2015 and December 2017 at Hanyang University Guri Hospital. Patients with appendicitis or cholecystitis were excluded from this study because of the simplicity of the technique and the favorable postoperative prognosis. Surgical outcomes including open conversion, morbidity, mortality, risk, and prognostic factors were evaluated. RESULTS During the study period, 125 patients (84.5%) underwent laparoscopic surgery. The conversion to open surgery occurred in 7 (5.3%) patients. In the laparoscopic surgery group, 27 patients (21.6%) experienced postoperative complications, and 6 died (4.8%). Multivariate analysis showed that age of older than 75 years was a risk factor for postoperative complications. Especially, preoperative shock (<90 mm Hg) and a longer time from symptom onset (over 2 d) to surgery were prognostic factors for postoperative mortality. CONCLUSIONS On the basis of our results and experiences, we believe that laparoscopic surgery is applicable to surgery of pan-peritonitis. And, preoperative shock and longer time from onset are prognostic factors of mortality in laparoscopic group. Therefore, we are confident that careful patient selection and specialized laparoscopic team should be considered in order to have best results.
Collapse
|
8
|
Assessment of PULP score in predicting 30-day perforated duodenal ulcer morbidity, and comparison of its performance with Boey and ASA, a retrospective study. Ann Med Surg (Lond) 2019; 42:23-28. [PMID: 31193430 PMCID: PMC6527942 DOI: 10.1016/j.amsu.2019.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/06/2019] [Accepted: 05/04/2019] [Indexed: 12/23/2022] Open
Abstract
Background /aim: Scores commonly employed to risk stratify perforated peptic ulcer patients include ASA (American Society of Anesthesiologists), Boey and peptic ulcer perforation score (PULP). However, few studies assessed and compared the accuracy indices of these three scores in predicting post PPU repair 30-day morbidity. We assessed accuracy indices of PULP, and compared them to Boey and ASA in predicting post perforated duodenal (PDU) ulcer repair 30-day morbidity. Methods Retrospective chart review of all PDU patients (perforated duodenal ulcers only) at the largest two hospitals in Qatar (N = 152). Data included demographic, clinical, laboratory, operative, and post repair 30-day morbidity. Area under the Curve (AUC), sensitivity and specificity were computed for each of the 3 scores. Multivariate logistic regression assessed the accuracy indices of each score. Results All patients were males (M age 37.41 years). Post PDU repair 30-day morbidity was 10.5% (16 morbidities). Older age, higher ASA (≥3), Boey (≥1) or PULP (≥8) scores, shock on admission and preoperative comorbidities; and conversely, lower hemoglobin and albumin were all positively significantly associated with higher post PDU 30-day morbidity. PULP displayed the largest AUC (72%), and was the only score to significantly predict 30-day morbidity. The current study is the first to report the sensitivity and specificity of these three scores for post PDU repair 30-day morbidity; and first to assess accuracy indices for PULP in predicting post PDU repair 30-day morbidity. Conclusion PULP score had the largest AUC and was the only score to significantly predict post PDU repair 30-day morbidity. The current study is the first to report the sensitivity and specificity of the three scoring systems (ASA, Boey and PULP) for post perforated duodenal ulcer repair 30-day morbidity. It is also the first study to assess accuracy indices for PULP in predicting post perforated duodenal ulcer repair 30-day morbidity. Compared with ASA and Boey, PULP score had the largest area under the curve and was the only score to significantly predict post perforated duodenal ulcer repair 30-day morbidity.
Collapse
|
9
|
Tan S, Wu G, Zhuang Q, Xi Q, Meng Q, Jiang Y, Han Y, Yu C, Yu Z, Li N. Laparoscopic versus open repair for perforated peptic ulcer: A meta analysis of randomized controlled trials. Int J Surg 2016; 33 Pt A:124-32. [PMID: 27504848 DOI: 10.1016/j.ijsu.2016.07.077] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/20/2016] [Accepted: 07/30/2016] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The role of laparoscopic surgery in the repair for peptic ulcer disease is unclear. The present study aimed to compare the safety and efficacy of laparoscopic versus open repair for peptic ulcer disease. METHODS Randomized controlled trials (RCTs) comparing laparoscopic versus open repair for peptic ulcer disease were identified from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and references of identified articles and relevant reviews. Primary outcomes were postoperative complications, mortality, and reoperation. Secondary outcomes were operative time, postoperative pain, postoperative hospital stay, nasogastric tube duration, and time to resume diet. Statistical analysis was carried out by Review Manage software. RESULTS Five RCTs investigating a total of 549 patients, of whom, 279 received laparoscopic repair and 270 received open repair, were included in the final analysis. There were no significant differences between these two procedures in some primary outcomes including overal postoperative complication rate, mortality, and reoperation rate. Subcategory analysis of postoperative complications showed that laparoscopic repair had also similar rates of repair site leakage, intra-abdominal abscess, postoperative ileus, pneumonia, and urinary tract infection as open surgery, except of the lower surgical site infection rate (P < 0.05). In addition, there were also no significant differences between these two procedures in some second outcomes including operative time, postoperative hospital stay, and time to resume diet, but laparoscopic repair had shorter nasogastric tube duration (P < 0.05) and less postoperative pain (P < 0.05) than open surgery. CONCLUSIONS Laparoscopic surgery is comparable with open surgery in the setting of repair for perforated peptic ulcer. The obvious advantages of laparoscopic surgery are the lower surgical site infection rate, shorter nasogastric tube duration and less postoperative pain. However, more higher quality studies should be undertaken to further assess the safety and efficacy of laparoscopic repair for peptic ulcer disease.
Collapse
Affiliation(s)
- Shanjun Tan
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China
| | - Guohao Wu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
| | - Qiulin Zhuang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China
| | - Qiulei Xi
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China
| | - Qingyang Meng
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China
| | - Yi Jiang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China
| | - Yusong Han
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China
| | - Chao Yu
- Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, PR China
| | - Zhen Yu
- Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, PR China
| | - Ning Li
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province 210002, PR China
| |
Collapse
|
10
|
Kim HI, Kim MG. Entirely Laparoscopic Gastrectomy and Colectomy for Remnant Gastric Cancer with Gastric Outlet Obstruction and Transverse Colon Invasion. J Gastric Cancer 2015; 15:286-9. [PMID: 26819808 PMCID: PMC4722996 DOI: 10.5230/jgc.2015.15.4.286] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 12/30/2022] Open
Abstract
It is well known that gastrectomy with curative intent is the best way to improve outcomes of patients with remnant gastric cancer. Recently,several investigators reported their experiences with laparoscopic gastrectomy of remnant gastric cancer. We report the case of an 83-year-old female patient who was diagnosed with remnant gastric cancer with obstruction. She underwent an entirely laparoscopic distal gastrectomy with colectomy because of direct invasion of the transverse colon. The operation time was 200 minutes. There were no postoperative complications. The pathologic stage was T4b (transverse colon) N0M0. Our experience suggests that laparoscopic surgerycould be an effective method to improve the surgical outcomes of remnant gastric cancer patients.
Collapse
Affiliation(s)
- Hyun Il Kim
- Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Min Gyu Kim
- Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea
| |
Collapse
|