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Natural orifice transluminal endoscopic surgery for patients with perforated peptic ulcer

Eduardo A Bonin1, Erica Moran, Christopher J Gostout

  • 1Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.

Surgical Endoscopy
|December 20, 2011
PubMed

Insights

Perforated peptic ulcers cause significant mortality. A minimally invasive transluminal endoscopic omental patch repair may be suitable for over half of patients, offering a new treatment option.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Minimally Invasive Procedures

Background:

  • Perforated peptic ulcers are a leading cause of mortality, often requiring surgical intervention.
  • While laparoscopic repair is effective, it is not widely adopted.
  • Transluminal endoscopic omental patch closure presents a potential minimally invasive alternative.

Purpose of the Study:

  • To evaluate the potential candidacy of patients with perforated peptic ulcers for transluminal endoscopic omental patch closure.
  • To assess the feasibility of a minimally invasive approach for this critical condition.

Main Methods:

  • A retrospective review of 104 patients with perforated peptic ulcers from 2005-2010.
  • Data collected included demographics, ulcer characteristics, surgical procedures, and outcomes.
  • Candidacy for endoscopic transluminal repair was determined by specific criteria, including suitability for omental patch closure and absence of contraindications.

Main Results:

  • Over half (52%) of the 104 patients were identified as potential candidates for transluminal repair.
  • Medication-related ulcers were common (63%), and the 1-year mortality rate was high (35%).
  • Open omental patch repair was the predominant surgical method (80% of omental patches).

Conclusions:

  • Transluminal endoscopic repair offers a promising minimally invasive option for a significant subset of patients with perforated peptic ulcers.
  • This approach could improve outcomes and reduce the invasiveness of treatment for selected individuals.
  • Further research into this technique is warranted to optimize patient selection and procedural success.
Abstract

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