1. Laparoscopic omental patch for perforated peptic ulcer disease reduces length of stay and complications, compared to open surgery: A SWSC multicenter study
- Author
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Eric M. Campion, Justin L. Regner, Brandon Bruns, Cressilee Bryant, Richard C. Frazee, Esteban C. Esquivel, Barbara Eaton, Matthew Bartley, Adel Alhaj Saleh, John Lung, Jeremy L. Ward, Mhd Hasan Almekdash, Elizabeth P. Scherer, Alexander Raines, Christopher Crane, Eliza E. Moskowitz, Thomas J. Schroeppel, Sharmila Dissanaike, Jared Mortus, Galinos Barmparas, and Daniel R. Margulies
- Subjects
Male ,medicine.medical_specialty ,Demographics ,Operative Time ,Disease ,030230 surgery ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Humans ,Medicine ,Practice Patterns, Physicians' ,business.industry ,Open surgery ,digestive, oral, and skin physiology ,General Medicine ,Length of Stay ,Middle Aged ,equipment and supplies ,medicine.disease ,United States ,Surgery ,Omental patch ,Multicenter study ,030220 oncology & carcinogenesis ,Peptic ulcer ,Peptic Ulcer Perforation ,General practice ,Operative time ,Female ,Laparoscopy ,business ,Omentum ,human activities - Abstract
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.
- Published
- 2019
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