Although laparoscopic repair (LR) of perforated peptic ulcers (PPUs) has long been accepted, clinical evidence comparing LR versus open repair (OR) remains lacking. The aim of this study is to evaluate the feasibility, safety and outcome of laparoscopic gastric repair and compare it with the outcome open repair by relying on a propensity score matching statistical technique
Despite the evolution of medical management of Gastroduodenal Peptic Ulcer (GPU), complications like bleeding and perforation are still not uncommon in clinical practice. According to the literature in average, 2-14% of peptic ulcers result in perforation, most 215 commonly occurring in females over the age of 60 and chronic NSAID, alcohol or tobacco users. Management of perforated peptic ulcer entails resuscitation, pharmacotherapy and surgery. Traditionally, suture with or without omental patch has been considered the 'gold standard' and still is. It is associated with shorter length of stay, lower transfusion needs and has lower morbidity as compared to gastrectomy. In 1992, it has been proposed that laparoscopy should be routinely considered in the management of perforated duodenal ulcer. Nowadays due to the advances in laparoscopic technique, many publications suggest that laparoscopic repair of perforated peptic ulcers could be a superior choice to open repair. These is linked with the advantages of laparoscopic surgery over open surgery such as reduced postoperative pain, lower wound infection rate, decreased length of hospital stay, and earlier functional recovery
Study Type
OBSERVATIONAL
Enrollment
200
Simple suture with or without omental protective patch
Policlinico San Pietro
Ponte San Pietro, Bergamo, Italy
RECRUITINGArcispedale S. Anna di Cona - Azienda Ospedaliero-Universitaria di Ferrara
Ferrara, Emilia-Romagna, Italy
30-day Mortality Rate
Time frame: 18 months
30-day Morbidity Rate
Morbidity defined by mean of the most used classification scoring system
Time frame: 18 months
Conversion rate
Defined when a procedure was attempted via the minimally invasive approach but required an open incision to be completed
Time frame: 18 months
Calculation of Boey index
Calculation and evaluation of its predictive value for morbidity and mortality
Time frame: 18 months
Calculation of Mannheim Peritonitis Index
Calculation and evaluation of its predictive value for morbidity and mortality
Time frame: 18 months
Calculation of Shock index
Calculation and evaluation of its predictive value for morbidity and mortality
Time frame: 18 months
Calculation of Age-related shock index
Calculation and evaluation of its predictive value for morbidity and mortality
Time frame: 18 months
Operative time
The duration time of surgical step from in The duration of the surgical procedure
Time frame: 18 months
Calculation of Charlson Age-Comorbidity Index (CACI)
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Azienda Ospedaliera San Camillo Forlanini di Roma
Rome, Lazio, Italy
RECRUITINGOspedale Cristo Re
Rome, Lazio, Italy
RECRUITINGFondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
Milan, Lombardy, Italy
RECRUITINGOspedale Civile di Adria
Adria, Rovigo, Italy
RECRUITINGCagliari University Hospital Monserrato
Cagliari, Sardinia, Italy
RECRUITINGAzienda Ospedaliero Universitaria Ospedale Riuniti Ancona
Ancona, The Marches, Italy
RECRUITINGOspedale della Misericordia Grosseto
Grosseto, Tuscany, Italy
RECRUITINGAzienda Ospedaliera Pisana Policlinico Universitario Cisanello
Pisa, Tuscany, Italy
RECRUITING...and 3 more locations
Calculation and evaluation of its predictive value for morbidity and mortality
Time frame: 18 months