Impact of adherence of pus moss on the efficacy of different surgical procedures for perforated peptic ulcers / 实用医学杂志

ABSTRACT

Objective To study the effects of intraperitoneal adherence of pus mosses on the efficacy of open repair(OR)and laparoscopic repair(LR)for perforated peptic ulcers(PPUs). Methods Intraperitonealad-herence of pus mosses was divided into the first,second and third stage,respectively. Surgical duration,volume of peritoneal drainage ,rate of abnormal wound healing ,number of intensive care unit transfer ,recovery time of bowel function ,ambulation time ,length of hospital stay ,and postoperative treatment abandonment rate were compared. Results There were 78 ,46 ,and 29 patients for the three stages in OR group ,and 71 ,39 ,and 15 patients in LR group,respectively. There were significant differences insurgical duration,volume of peritoneal drainage,rate of abnormalwound healing,number of ICU transfer,recovery time of bowel function,ambulation time,length of hospital stay about the first stage between the two surgical methods(P values were 0.000,0.000, 0.015,0.000,0.000,0.000,and 0.043 respectively)except for treatment abandonment rate(P value was 0.209). There were significant differences in volume of peritoneal drainage ,rate of abnormal wound healing ,number of ICU transfer,recovery time of bowel function,ambulation time,and length of hospital stay(P values were 0.000, 0.033,0.000,0.000,0.001,and 0.028 respectively)for the second stage except surgical duration and treatment abandonment rate(P values were 0.196 and 0.358 respectively) between the two procedures. The differences were significant in surgical duration ,volume of peritoneal drainage ,and length of hospital stay between the two methods (P values were 0.039 ,0.003 ,0.024 ,and 0.002 respectively) for the third stage but there were no significant differencesin rate of abnormal wound healing , number of ICU transfer , recovery time of bowel function ,ambulation time ,and treatment abandonment rate (P values were 0.175 ,0.173 ,0.766 ,and 0.757 respectively). Conclusions LR is superior to OR under the first stage of pus moss and still has advantages under the second stage. However,LR may be inferior to OR under the third stage.