Alemrajabi Mahdi, Safari Saeed, Tizmaghz Adnan, Alemrajabi Fatemeh, Shabestanipour Ghazaal
MD., Assistant Professor of Colorectal Surgery, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran.
MD., Assistant Professor of General Surgery, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran.
Electron Physician. 2016 Jun 25;8(6):2543-5. doi: 10.19082/2543. eCollection 2016 Jun.
The mainstay of treatment for perforated peptic ulcer is Omental patch closure. With the advent of laparoscopic surgery, this approach is being used for the treatment of perforated peptic ulcer. The aim of this study was to evaluate the outcome of laparoscopy in Firoozgar general hospital over a period of 18 months. The outcome of the laparoscopic approach and the associated morbidity and mortality, operation time, conversion rate and hospital stay were assessed.
A prospective analysis of 29 consecutive patients (mean age 37.5 years; 23 men) with perforated peptic ulcers and who had undergone laparoscopic surgery was carried over a period of 18 months from March 2014 until September 2015. Pre-operative, intra-operative, and post-operative clinical data were collectively analyzed by SPSS 19 for Windows.
Seventeen patients had a history of cigarette smoking, 11 patients had a history of opium consumption, 19 were chronic NSAID users, 26 had Helicobacter pylori infections, and six had a co-morbid condition. Previous surgical history included laparotomy for pancreatic cancer in two patients, for sigmoid colon cancer in one patient, and for acute appendicitis in four patients. The average operating time for all cases was 47.5 + 20 min. The mean lag time between onset of symptoms and surgery was 20.4 hours. All patients underwent laparoscopic closure of the perforation with Omental patch closure. No morbidity was observed, and none of the patients needed conversion to open surgery. One patient died after 11 months of follow-up due to the progression of underlying pancreatic cancer. The mean postoperative hospital stay was 4.2 days.
The results of the laparoscopic approach for perforated peptic ulcer were promising, with no conversion to open surgery, no morbidity, and mortality.
穿孔性消化性溃疡的主要治疗方法是网膜修补术。随着腹腔镜手术的出现，这种方法正被用于治疗穿孔性消化性溃疡。本研究的目的是评估菲鲁兹加尔综合医院18个月期间腹腔镜手术的结果。评估了腹腔镜手术方法及其相关的发病率、死亡率、手术时间、中转率和住院时间。
对2014年3月至2015年9月期间连续29例接受腹腔镜手术的穿孔性消化性溃疡患者（平均年龄37.5岁；23例男性）进行前瞻性分析。术前、术中和术后临床数据由SPSS 19 for Windows进行综合分析。
17例患者有吸烟史，11例有鸦片吸食史，19例长期使用非甾体抗炎药，26例有幽门螺杆菌感染，6例有合并症。既往手术史包括2例因胰腺癌行剖腹手术，1例因乙状结肠癌行剖腹手术，4例因急性阑尾炎行剖腹手术。所有病例的平均手术时间为47.5±20分钟。症状出现至手术的平均间隔时间为20.4小时。所有患者均接受了腹腔镜穿孔修补术加网膜修补术。未观察到并发症，且无一例患者需要中转开腹手术。1例患者在随访11个月后因潜在胰腺癌进展死亡。术后平均住院时间为4.2天。
腹腔镜治疗穿孔性消化性溃疡的结果令人满意，无需中转开腹手术，无并发症和死亡。
