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Laparoscopic repair for perforated peptic ulcer: a randomized controlled trial
Wing T Siu1, Heng T Leong, Bonita K B Law
1Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, SAR, China. siuwt@hongkong.com
Annals of Surgery
|March 8, 2002
Summary
Laparoscopic repair of perforated peptic ulcers offers a safer and more effective treatment than open repair. This minimally invasive approach leads to reduced pain, shorter hospital stays, and faster recovery.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Perforated peptic ulcer treatment traditionally involves omental patch repair with peritoneal lavage.
- Laparoscopic repair has emerged as an alternative since 1990, but robust comparative data are limited.
Purpose of the Study:
- To compare the efficacy and outcomes of open versus laparoscopic omental patch repair for perforated peptic ulcers.
Main Methods:
- A randomized controlled trial involving 121 patients with perforated peptic ulcers.
- Patients were assigned to undergo either open or laparoscopic repair, with specific exclusion criteria and conversion protocols.
- Outcomes assessed included analgesic requirements, operative time, pain scores, hospital stay, complications, and return to daily activities.
Main Results:
- Laparoscopic repair resulted in significantly lower parenteral analgesic requirements and pain scores.
- The laparoscopic group experienced shorter operative times and a shorter median postoperative hospital stay (6 vs. 7 days).
- Fewer chest infections were observed in the laparoscopic group, with similar rates of intra-abdominal collections.
Conclusions:
- Laparoscopic repair is a safe and reliable method for treating perforated peptic ulcers.
- It demonstrates advantages over open repair, including reduced operating time, less postoperative pain, fewer complications, and quicker recovery.