Aljuhani Suhad A, Sherwani Ahmad A, Alnamshah Fahad O, Alaeq Rana A, Alrahma Husain A, Jarad Mada M, Hakami Arwa A, Mobarki Tasneem H, Al-Khairat Hamood K, Sahal Yasir A, Bakhsh Abdulelah W
General Surgery, Al Thager Hospital, Jeddah, SAU.
General Surgery, King Fahad Central Hospital, Jazan, SAU.
Cureus. 2024 Jun 30;16(6):e63523. doi: 10.7759/cureus.63523. eCollection 2024 Jun.
Peptic ulcer disease (PUD) poses a significant global healthcare challenge, with an intricate interplay between stomach acid-pepsin levels and mucosal protective mechanisms. The emergence of Helicobacter pylori (H. pylori) as a major etiological factor revolutionized the therapeutic landscape, highlighting the importance of bacterial eradication in PUD management. Surgical intervention remains vital, particularly in cases of perforated peptic ulcers, despite a shift towards conservative approaches. Understanding the impact of H. pylori eradication on surgical outcomes is crucial for optimizing PUD management. This systematic review was conducted to assess how H. pylori eradication treatment impacts surgical results in patients with PUD. The criteria for inclusion involved research studies on individuals aged 18 years and older with a diagnosis of PUD that necessitated surgical treatment. Important results comprised eradication rates, complications after surgery, recurrence rates, and overall outcomes for patients. Two researchers independently screened and extracted data from electronic databases using a thorough search strategy. The evaluation of quality employed standardized instruments for randomized controlled trials and cohort studies. Nine research projects met the requirements for inclusion, offering information on the effectiveness of H. pylori elimination treatment on surgical results. Different rates of eradication were noted, with a notable number of patients experiencing postoperative complications. Recurrence of ulcers was a concern, despite treatment, emphasizing the complexity of PUD management. Studies have shown that eradication therapy is effective in certain patient groups, like young men with perforated peptic ulcers. Still, there are obstacles, especially for patients who test negative for H. pylori and experience recurring ulcers. The integration of H. pylori eradication with surgical intervention represents a holistic approach to PUD management. Although eradication therapy has the potential to enhance surgical results, difficulties remain, requiring personalized treatment approaches that consider patients' unique characteristics and the cause of the disease. This research adds to the growing knowledge of PUD treatment, stressing the importance of proper management.
消化性溃疡病（PUD）是一项重大的全球医疗挑战，胃酸 - 胃蛋白酶水平与黏膜保护机制之间存在复杂的相互作用。幽门螺杆菌（H. pylori）作为主要病因的出现彻底改变了治疗格局，凸显了根除细菌在PUD管理中的重要性。尽管治疗方式已转向保守治疗，但手术干预仍然至关重要，尤其是在消化性溃疡穿孔的病例中。了解根除幽门螺杆菌对手术结果的影响对于优化PUD管理至关重要。本系统评价旨在评估根除幽门螺杆菌治疗对PUD患者手术结果的影响。纳入标准包括对18岁及以上诊断为PUD且需要手术治疗的个体进行的研究。重要结果包括根除率、术后并发症、复发率以及患者的总体结局。两名研究人员使用全面的搜索策略从电子数据库中独立筛选和提取数据。采用标准化工具对随机对照试验和队列研究进行质量评估。九个研究项目符合纳入要求，提供了关于根除幽门螺杆菌治疗对手术结果有效性的信息。观察到不同的根除率，相当数量的患者出现术后并发症。尽管进行了治疗，但溃疡复发仍是一个问题，这凸显了PUD管理的复杂性。研究表明，根除治疗在某些患者群体中有效，如患有消化性溃疡穿孔的年轻男性。然而，仍存在障碍，特别是对于幽门螺杆菌检测呈阴性且溃疡复发的患者。将根除幽门螺杆菌与手术干预相结合代表了一种全面的PUD管理方法。尽管根除治疗有可能改善手术结果，但困难仍然存在，需要考虑患者独特特征和疾病病因的个性化治疗方法。这项研究增加了对PUD治疗的认识，强调了合理管理的重要性。
