Pang Yu-Fan, Shu Liang, Xia Cheng-Wei
Department of Thyroid Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
World J Gastrointest Surg. 2025 Feb 27;17(2):101896. doi: 10.4240/wjgs.v17.i2.101896.
Gastric ulcer perforation is a critical condition that can lead to significant morbidity and mortality if not promptly addressed. It is often the result of chronic peptic ulcer disease, which is characterized by a breach in the gastric wall due to ulceration. Surgical intervention is essential for managing this life-threatening complication. However, the optimal surgical technique remains debatable among clinicians. Various methods have been employed, including simple closure, omental patch repair, and partial gastrectomy, each with distinct advantages and disadvantages. Understanding the comparative efficacy and postoperative outcomes of these techniques is crucial for improving patient care and surgical decision-making. This study addresses the need for a comprehensive analysis in this area.
To compare the efficacy and postoperative complications of different surgical methods for the treatment of gastric ulcer perforation.
A retrospective analysis was conducted on 120 patients who underwent surgery for gastric ulcer perforation between September 2020 and June 2023. The patients were divided into three groups based on the surgical method: Simple closure, omental patch repair, and partial gastrectomy. The primary outcomes were the operative success rate and incidence of postoperative complications. Secondary outcomes included the length of hospital stay, recovery time, and long-term quality of life.
The operative success rates for simple closure, omental patch repair, and partial gastrectomy were 92.5%, 95%, and 97.5%, respectively. Postoperative complications occurred in 20%, 15%, and 17.5% of patients in each group, respectively. The partial gastrectomy group showed a significantly longer operative time ( < 0.001) but the lowest rate of ulcer recurrence (2.5%, < 0.05). The omental patch repair group demonstrated the shortest hospital stay (mean 7.2 days, < 0.05) and fastest recovery time.
While all three surgical methods showed high success rates, omental patch repair demonstrated the best overall outcomes, with a balance of high efficacy, low complication rates, and shorter recovery time. However, the choice of the surgical method should be tailored to individual patient factors and the surgeon's expertise.
胃溃疡穿孔是一种危急情况,如果不及时处理,可导致严重的发病率和死亡率。它通常是慢性消化性溃疡病的结果,其特征是由于溃疡导致胃壁破裂。手术干预对于处理这种危及生命的并发症至关重要。然而,最佳手术技术在临床医生中仍存在争议。已采用了各种方法,包括单纯缝合、网膜修补和胃部分切除术,每种方法都有各自的优缺点。了解这些技术的比较疗效和术后结果对于改善患者护理和手术决策至关重要。本研究满足了该领域进行全面分析的需求。
比较不同手术方法治疗胃溃疡穿孔的疗效和术后并发症。
对2020年9月至2023年6月期间接受胃溃疡穿孔手术的120例患者进行回顾性分析。根据手术方法将患者分为三组:单纯缝合、网膜修补和胃部分切除术。主要结局是手术成功率和术后并发症发生率。次要结局包括住院时间、恢复时间和长期生活质量。
单纯缝合、网膜修补和胃部分切除术的手术成功率分别为92.5%、95%和97.5%。每组患者术后并发症发生率分别为20%、15%和17.5%。胃部分切除术组手术时间明显更长(<0.001),但溃疡复发率最低(2.5%,<0.05)。网膜修补组住院时间最短(平均7.2天,<0.05),恢复时间最快。
虽然三种手术方法均显示出较高的成功率,但网膜修补术总体效果最佳,在疗效高、并发症发生率低和恢复时间短之间取得了平衡。然而,手术方法的选择应根据患者个体因素和外科医生的专业知识进行调整。