A comparative study on laparoscopic and open surgical approaches for perforated peptic ulcer repair: efficacy and outcomes analysis

• Published in: Langenbeck's archives of surgery 2023-11, Vol.408 (1), p.435-435, Article 435
• Main Authors: Li, Zi-Wei, Tong, Yue, Liu, Fei, Liu, Xu-Rui, Lv, Quan, Tang, Kai-Lin, Li, Lian-Shuo, Liu, Xiao-Yu, Zhang, Wei, Peng, Dong
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Cardiac Surgery; Databases, Factual; General Surgery; Humans; Laparoscopy - adverse effects; Length of Stay; Medicine; Medicine & Public Health; Odds Ratio; Peptic Ulcer Perforation - etiology; Peptic Ulcer Perforation - surgery; Postoperative Complications - etiology; Retrospective Studies; Thoracic Surgery; Traumatic Surgery; Treatment Outcome; Vascular Surgery
• ISSN: 1435-2451; 1435-2451
• DOI: 10.1007/s00423-023-03171-1

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.