TY - JOUR
T1 - Laparoscopic omental patch for perforated peptic ulcer disease reduces length of stay and complications, compared to open surgery
T2 - A SWSC multicenter study
AU - Alhaj Saleh, Adel
AU - Esquivel, Esteban C.
AU - Lung, John T.
AU - Eaton, Barbara C.
AU - Bruns, Brandon R.
AU - Barmparas, Galinos
AU - Margulies, Daniel R.
AU - Raines, Alexander
AU - Bryant, Cressilee
AU - Crane, Christopher E.
AU - Scherer, Elizabeth P.
AU - Schroeppel, Thomas J.
AU - Moskowitz, Eliza
AU - Regner, Justin
AU - Frazee, Richard
AU - Campion, Eric M.
AU - Bartley, Matthew
AU - Mortus, Jared
AU - Ward, Jeremy
AU - Almekdash, Mhd Hasan
AU - Dissanaike, Sharmila
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/12
Y1 - 2019/12
N2 - 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%, p < 0.05) as was unplanned re-operation (4.7% vs 14%, p < 0.05). Lap reduced LOS (6 vs 8 days, p < 0.001). Ileus was more in Lap (42% vs 18 p < 0.001) operative time was 14 min higher in Lap(p < 0.01) and admission to OR time was 4 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.
AB - 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%, p < 0.05) as was unplanned re-operation (4.7% vs 14%, p < 0.05). Lap reduced LOS (6 vs 8 days, p < 0.001). Ileus was more in Lap (42% vs 18 p < 0.001) operative time was 14 min higher in Lap(p < 0.01) and admission to OR time was 4 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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U2 - 10.1016/j.amjsurg.2019.09.002
DO - 10.1016/j.amjsurg.2019.09.002
M3 - Article
C2 - 31537324
AN - SCOPUS:85072206031
SN - 0002-9610
VL - 218
SP - 1060
EP - 1064
JO - American journal of surgery
JF - American journal of surgery
IS - 6
ER -