Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach

G. Costa; P. Fransvea; L. Lepre; G. Liotta; G. Mazzoni; A. Biloslavo; V. Bianchi; S. Occhionorelli; A. Costa; Gabriele Sganga; F. Agresta; G. Alemanno; M. Antropoli; N. Apice; G. Argenio; N. Avenia; A. Azzinnaro; A. Barberis; G. Badessi; G. Baldazzi; C. Bergamini; G. Bianco; A. Biloslavo; C. Bombardini; G. Borzellino; G. Brachini; B. G. Maurizio; T. Canini; G. T. Capolupo; F. Carannante; M. Caricato; D. Cassini; M. Castriconi; A. Catamero; M. Catarci; G. Ceccarelli; M. Ceresoli; M. Chiarugi; N. Cillara; R. Cirocchi; L. Cobuccio; F. Coccolini; G. Cocorullo; V. Cozza; Antonio Crucitti; E. Cucinotta; R. D'Alessio; Garberini A. de Manzoni; Manzini N. De; Nisco C. De; Prizio M. De; E. Finotti; P. Fransvea; B. Frezza; G. M. Garbarino; G. Garulli; M. Genna; S. Giannessi; A. Giordano; M. Guerrieri; V. Iacopini; H. Kurihara; Antonio La Greca; G. G. Laracca; E. Laterza; L. Lepre; G. Liotta; D. Mariani; P. Marini; R. Marzaioli; G. Masciana; G. Mazzoni; P. Mercantini; V. Miacci; A. Mingoli; G. Miranda; S. Occhionorelli; N. Paderno; G. M. Palini; D. Paradies; L. Petruzzelli; A. Pezzolla; D. Piazza; V. Piazza; G. Pignata; E. Pinotti; A. Pisanu; C. Puccioni; A. Rocca; F. Rondelli; P. Ruscelli; S. Paolo; M. Scattizzi; A. erao; Gabriele Sganga; D. Tartaglia; G. Tebala; C. Trana; M. Zago

doi:10.1007/s00464-023-09998-5

Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach

G. Costa, P. Fransvea^*, L. Lepre, G. Liotta, G. Mazzoni, A. Biloslavo, V. Bianchi, S. Occhionorelli, A. Costa, Gabriele Sganga, F. Agresta, G. Alemanno, M. Antropoli, N. Apice, G. Argenio, N. Avenia, A. Azzinnaro, A. Barberis, G. Badessi, G. BaldazziC. Bergamini, G. Bianco, A. Biloslavo, C. Bombardini, G. Borzellino, G. Brachini, B. G. Maurizio, T. Canini, G. T. Capolupo, F. Carannante, M. Caricato, D. Cassini, M. Castriconi, A. Catamero, M. Catarci, G. Ceccarelli, M. Ceresoli, M. Chiarugi, N. Cillara, R. Cirocchi, L. Cobuccio, F. Coccolini, G. Cocorullo, V. Cozza, Antonio Crucitti, E. Cucinotta, R. D'Alessio, Garberini A. de Manzoni, Manzini N. De, Nisco C. De, Prizio M. De, E. Finotti, P. Fransvea^*, B. Frezza, G. M. Garbarino, G. Garulli, M. Genna, S. Giannessi, A. Giordano, M. Guerrieri, V. Iacopini, H. Kurihara, Antonio La Greca, G. G. Laracca, E. Laterza, L. Lepre, G. Liotta, D. Mariani, P. Marini, R. Marzaioli, G. Masciana, G. Mazzoni, P. Mercantini, V. Miacci, A. Mingoli, G. Miranda, S. Occhionorelli, N. Paderno, G. M. Palini, D. Paradies, L. Petruzzelli, A. Pezzolla, D. Piazza, V. Piazza, G. Pignata, E. Pinotti, A. Pisanu, C. Puccioni, A. Rocca, F. Rondelli, P. Ruscelli, S. Paolo, M. Scattizzi, A. erao, Gabriele Sganga, D. Tartaglia, G. Tebala, C. Trana, M. Zago

^*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivista › Articolo in rivista

Abstract

Background: Perforated peptic ulcer (PPU) remain a surgical emergency accounting for 37% of all peptic ulcer-related deaths. Surgery remains the standard of care. The benefits of laparoscopic approach have been well-established even in the elderly. However, because of inconsistent results with specific regard to some technical aspects of such technique surgeons questioned the adoption of laparoscopic approach. This leads to choose the type of approach based on personal experience. The aim of our study was to critically appraise the use of the laparoscopic approach in PPU treatment comparing it with open procedure. Methods: A retrospective study with propensity score matching analysis of patients underwent surgical procedure for PPU was performed. Patients undergoing PPU repair were divided into: Laparoscopic approach (LapA) and Open approach (OpenA) groups and clinical-pathological features of patients in the both groups were compared. Results: A total of 453 patients underwent PPU simple repair. Among these, a LapA was adopted in 49% (222/453 patients). After propensity score matching, 172 patients were included in each group (the LapA and the OpenA). Analysis demonstrated increased operative times in the OpenA [OpenA: 96.4 ± 37.2 vs LapA 88.47 ± 33 min, p = 0.035], with shorter overall length of stay in the LapA group [OpenA 13 ± 12 vs LapA 10.3 ± 11.4 days p = 0.038]. There was no statistically significant difference in mortality [OpenA 26 (15.1%) vs LapA 18 (10.5%), p = 0.258]. Focusing on morbidity, the overall rate of 30-day postoperative morbidity was significantly lower in the LapA group [OpenA 67 patients (39.0%) vs LapA 37 patients (21.5%) p = 0.002]. When stratified using the Clavien–Dindo classification, the severity of postoperative complications was statistically different only for C–D 1–2. Conclusions: Based on the present study, we can support that laparoscopic suturing of perforated peptic ulcers, apart from being a safe technique, could provide significant advantages in terms of postoperative complications and hospital stay.

Lingua originale	English
pagine (da-a)	5137-5149
Numero di pagine	13
Rivista	Surgical Endoscopy
Volume	37
Numero di pubblicazione	7
DOI	https://doi.org/10.1007/s00464-023-09998-5
Stato di pubblicazione	Pubblicato - 2023

All Science Journal Classification (ASJC) codes

Surgery

Keywords

Laparoscopic approach
Perforated peptic ulcer
Surgical treatment

OSS delle Nazioni Unite

Questo processo contribuisce al raggiungimento dei seguenti obiettivi di sviluppo sostenibile

Accesso al documento

10.1007/s00464-023-09998-5

Altri file e collegamenti

Cita questo

Costa, G., Fransvea, P., Lepre, L., Liotta, G., Mazzoni, G., Biloslavo, A., Bianchi, V., Occhionorelli, S., Costa, A., Sganga, G., Agresta, F., Alemanno, G., Antropoli, M., Apice, N., Argenio, G., Avenia, N., Azzinnaro, A., Barberis, A., Badessi, G., ... Zago, M. (2023). Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach. Surgical Endoscopy, 37(7), 5137-5149. https://doi.org/10.1007/s00464-023-09998-5

@article{36d333541f6549c28d5ddbc909db4333,

title = "Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach",

abstract = "Background: Perforated peptic ulcer (PPU) remain a surgical emergency accounting for 37% of all peptic ulcer-related deaths. Surgery remains the standard of care. The benefits of laparoscopic approach have been well-established even in the elderly. However, because of inconsistent results with specific regard to some technical aspects of such technique surgeons questioned the adoption of laparoscopic approach. This leads to choose the type of approach based on personal experience. The aim of our study was to critically appraise the use of the laparoscopic approach in PPU treatment comparing it with open procedure. Methods: A retrospective study with propensity score matching analysis of patients underwent surgical procedure for PPU was performed. Patients undergoing PPU repair were divided into: Laparoscopic approach (LapA) and Open approach (OpenA) groups and clinical-pathological features of patients in the both groups were compared. Results: A total of 453 patients underwent PPU simple repair. Among these, a LapA was adopted in 49% (222/453 patients). After propensity score matching, 172 patients were included in each group (the LapA and the OpenA). Analysis demonstrated increased operative times in the OpenA [OpenA: 96.4 ± 37.2 vs LapA 88.47 ± 33 min, p = 0.035], with shorter overall length of stay in the LapA group [OpenA 13 ± 12 vs LapA 10.3 ± 11.4 days p = 0.038]. There was no statistically significant difference in mortality [OpenA 26 (15.1%) vs LapA 18 (10.5%), p = 0.258]. Focusing on morbidity, the overall rate of 30-day postoperative morbidity was significantly lower in the LapA group [OpenA 67 patients (39.0%) vs LapA 37 patients (21.5%) p = 0.002]. When stratified using the Clavien–Dindo classification, the severity of postoperative complications was statistically different only for C–D 1–2. Conclusions: Based on the present study, we can support that laparoscopic suturing of perforated peptic ulcers, apart from being a safe technique, could provide significant advantages in terms of postoperative complications and hospital stay.",

keywords = "Laparoscopic approach, Perforated peptic ulcer, Surgical treatment, Laparoscopic approach, Perforated peptic ulcer, Surgical treatment",

author = "G. Costa and P. Fransvea and L. Lepre and G. Liotta and G. Mazzoni and A. Biloslavo and V. Bianchi and S. Occhionorelli and A. Costa and Gabriele Sganga and F. Agresta and G. Alemanno and M. Antropoli and N. Apice and G. Argenio and N. Avenia and A. Azzinnaro and A. Barberis and G. Badessi and G. Baldazzi and C. Bergamini and G. Bianco and A. Biloslavo and C. Bombardini and G. Borzellino and G. Brachini and Maurizio, {B. G.} and T. Canini and Capolupo, {G. T.} and F. Carannante and M. Caricato and D. Cassini and M. Castriconi and A. Catamero and M. Catarci and G. Ceccarelli and M. Ceresoli and M. Chiarugi and N. Cillara and R. Cirocchi and L. Cobuccio and F. Coccolini and G. Cocorullo and V. Cozza and Antonio Crucitti and E. Cucinotta and R. D'Alessio and {de Manzoni}, {Garberini A.} and De, {Manzini N.} and De, {Nisco C.} and De, {Prizio M.} and E. Finotti and P. Fransvea and B. Frezza and Garbarino, {G. M.} and G. Garulli and M. Genna and S. Giannessi and A. Giordano and M. Guerrieri and V. Iacopini and H. Kurihara and {La Greca}, Antonio and Laracca, {G. G.} and E. Laterza and L. Lepre and G. Liotta and D. Mariani and P. Marini and R. Marzaioli and G. Masciana and G. Mazzoni and P. Mercantini and V. Miacci and A. Mingoli and G. Miranda and S. Occhionorelli and N. Paderno and Palini, {G. M.} and D. Paradies and L. Petruzzelli and A. Pezzolla and D. Piazza and V. Piazza and G. Pignata and E. Pinotti and A. Pisanu and C. Puccioni and A. Rocca and F. Rondelli and P. Ruscelli and S. Paolo and M. Scattizzi and A. erao and Gabriele Sganga and D. Tartaglia and G. Tebala and C. Trana and M. Zago",

year = "2023",

doi = "10.1007/s00464-023-09998-5",

language = "English",

volume = "37",

pages = "5137--5149",

journal = "Surgical Endoscopy",

issn = "0930-2794",

publisher = "Springer",

number = "7",

}

Costa, G, Fransvea, P, Lepre, L, Liotta, G, Mazzoni, G, Biloslavo, A, Bianchi, V, Occhionorelli, S, Costa, A, Sganga, G, Agresta, F, Alemanno, G, Antropoli, M, Apice, N, Argenio, G, Avenia, N, Azzinnaro, A, Barberis, A, Badessi, G, Baldazzi, G, Bergamini, C, Bianco, G, Biloslavo, A, Bombardini, C, Borzellino, G, Brachini, G, Maurizio, BG, Canini, T, Capolupo, GT, Carannante, F, Caricato, M, Cassini, D, Castriconi, M, Catamero, A, Catarci, M, Ceccarelli, G, Ceresoli, M, Chiarugi, M, Cillara, N, Cirocchi, R, Cobuccio, L, Coccolini, F, Cocorullo, G, Cozza, V, Crucitti, A, Cucinotta, E, D'Alessio, R, de Manzoni, GA, De, MN, De, NC, De, PM, Finotti, E, Fransvea, P, Frezza, B, Garbarino, GM, Garulli, G, Genna, M, Giannessi, S, Giordano, A, Guerrieri, M, Iacopini, V, Kurihara, H, La Greca, A, Laracca, GG, Laterza, E, Lepre, L, Liotta, G, Mariani, D, Marini, P, Marzaioli, R, Masciana, G, Mazzoni, G, Mercantini, P, Miacci, V, Mingoli, A, Miranda, G, Occhionorelli, S, Paderno, N, Palini, GM, Paradies, D, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Pignata, G, Pinotti, E, Pisanu, A, Puccioni, C, Rocca, A, Rondelli, F, Ruscelli, P, Paolo, S, Scattizzi, M, erao, A, Sganga, G, Tartaglia, D, Tebala, G, Trana, C & Zago, M 2023, 'Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach', Surgical Endoscopy, vol. 37, n. 7, pagg. 5137-5149. https://doi.org/10.1007/s00464-023-09998-5

TY - JOUR

T1 - Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach

AU - Costa, G.

AU - Fransvea, P.

AU - Lepre, L.

AU - Liotta, G.

AU - Mazzoni, G.

AU - Biloslavo, A.

AU - Bianchi, V.

AU - Occhionorelli, S.

AU - Costa, A.

AU - Sganga, Gabriele

AU - Agresta, F.

AU - Alemanno, G.

AU - Antropoli, M.

AU - Apice, N.

AU - Argenio, G.

AU - Avenia, N.

AU - Azzinnaro, A.

AU - Barberis, A.

AU - Badessi, G.

AU - Baldazzi, G.

AU - Bergamini, C.

AU - Bianco, G.

AU - Biloslavo, A.

AU - Bombardini, C.

AU - Borzellino, G.

AU - Brachini, G.

AU - Maurizio, B. G.

AU - Canini, T.

AU - Capolupo, G. T.

AU - Carannante, F.

AU - Caricato, M.

AU - Cassini, D.

AU - Castriconi, M.

AU - Catamero, A.

AU - Catarci, M.

AU - Ceccarelli, G.

AU - Ceresoli, M.

AU - Chiarugi, M.

AU - Cillara, N.

AU - Cirocchi, R.

AU - Cobuccio, L.

AU - Coccolini, F.

AU - Cocorullo, G.

AU - Cozza, V.

AU - Crucitti, Antonio

AU - Cucinotta, E.

AU - D'Alessio, R.

AU - de Manzoni, Garberini A.

AU - De, Manzini N.

AU - De, Nisco C.

AU - De, Prizio M.

AU - Finotti, E.

AU - Fransvea, P.

AU - Frezza, B.

AU - Garbarino, G. M.

AU - Garulli, G.

AU - Genna, M.

AU - Giannessi, S.

AU - Giordano, A.

AU - Guerrieri, M.

AU - Iacopini, V.

AU - Kurihara, H.

AU - La Greca, Antonio

AU - Laracca, G. G.

AU - Laterza, E.

AU - Lepre, L.

AU - Liotta, G.

AU - Mariani, D.

AU - Marini, P.

AU - Marzaioli, R.

AU - Masciana, G.

AU - Mazzoni, G.

AU - Mercantini, P.

AU - Miacci, V.

AU - Mingoli, A.

AU - Miranda, G.

AU - Occhionorelli, S.

AU - Paderno, N.

AU - Palini, G. M.

AU - Paradies, D.

AU - Petruzzelli, L.

AU - Pezzolla, A.

AU - Piazza, D.

AU - Piazza, V.

AU - Pignata, G.

AU - Pinotti, E.

AU - Pisanu, A.

AU - Puccioni, C.

AU - Rocca, A.

AU - Rondelli, F.

AU - Ruscelli, P.

AU - Paolo, S.

AU - Scattizzi, M.

AU - erao, A.

AU - Sganga, Gabriele

AU - Tartaglia, D.

AU - Tebala, G.

AU - Trana, C.

AU - Zago, M.

PY - 2023

Y1 - 2023

N2 - Background: Perforated peptic ulcer (PPU) remain a surgical emergency accounting for 37% of all peptic ulcer-related deaths. Surgery remains the standard of care. The benefits of laparoscopic approach have been well-established even in the elderly. However, because of inconsistent results with specific regard to some technical aspects of such technique surgeons questioned the adoption of laparoscopic approach. This leads to choose the type of approach based on personal experience. The aim of our study was to critically appraise the use of the laparoscopic approach in PPU treatment comparing it with open procedure. Methods: A retrospective study with propensity score matching analysis of patients underwent surgical procedure for PPU was performed. Patients undergoing PPU repair were divided into: Laparoscopic approach (LapA) and Open approach (OpenA) groups and clinical-pathological features of patients in the both groups were compared. Results: A total of 453 patients underwent PPU simple repair. Among these, a LapA was adopted in 49% (222/453 patients). After propensity score matching, 172 patients were included in each group (the LapA and the OpenA). Analysis demonstrated increased operative times in the OpenA [OpenA: 96.4 ± 37.2 vs LapA 88.47 ± 33 min, p = 0.035], with shorter overall length of stay in the LapA group [OpenA 13 ± 12 vs LapA 10.3 ± 11.4 days p = 0.038]. There was no statistically significant difference in mortality [OpenA 26 (15.1%) vs LapA 18 (10.5%), p = 0.258]. Focusing on morbidity, the overall rate of 30-day postoperative morbidity was significantly lower in the LapA group [OpenA 67 patients (39.0%) vs LapA 37 patients (21.5%) p = 0.002]. When stratified using the Clavien–Dindo classification, the severity of postoperative complications was statistically different only for C–D 1–2. Conclusions: Based on the present study, we can support that laparoscopic suturing of perforated peptic ulcers, apart from being a safe technique, could provide significant advantages in terms of postoperative complications and hospital stay.

AB - Background: Perforated peptic ulcer (PPU) remain a surgical emergency accounting for 37% of all peptic ulcer-related deaths. Surgery remains the standard of care. The benefits of laparoscopic approach have been well-established even in the elderly. However, because of inconsistent results with specific regard to some technical aspects of such technique surgeons questioned the adoption of laparoscopic approach. This leads to choose the type of approach based on personal experience. The aim of our study was to critically appraise the use of the laparoscopic approach in PPU treatment comparing it with open procedure. Methods: A retrospective study with propensity score matching analysis of patients underwent surgical procedure for PPU was performed. Patients undergoing PPU repair were divided into: Laparoscopic approach (LapA) and Open approach (OpenA) groups and clinical-pathological features of patients in the both groups were compared. Results: A total of 453 patients underwent PPU simple repair. Among these, a LapA was adopted in 49% (222/453 patients). After propensity score matching, 172 patients were included in each group (the LapA and the OpenA). Analysis demonstrated increased operative times in the OpenA [OpenA: 96.4 ± 37.2 vs LapA 88.47 ± 33 min, p = 0.035], with shorter overall length of stay in the LapA group [OpenA 13 ± 12 vs LapA 10.3 ± 11.4 days p = 0.038]. There was no statistically significant difference in mortality [OpenA 26 (15.1%) vs LapA 18 (10.5%), p = 0.258]. Focusing on morbidity, the overall rate of 30-day postoperative morbidity was significantly lower in the LapA group [OpenA 67 patients (39.0%) vs LapA 37 patients (21.5%) p = 0.002]. When stratified using the Clavien–Dindo classification, the severity of postoperative complications was statistically different only for C–D 1–2. Conclusions: Based on the present study, we can support that laparoscopic suturing of perforated peptic ulcers, apart from being a safe technique, could provide significant advantages in terms of postoperative complications and hospital stay.

KW - Laparoscopic approach

KW - Perforated peptic ulcer

KW - Surgical treatment

KW - Laparoscopic approach

KW - Perforated peptic ulcer

KW - Surgical treatment

UR - https://publicatt.unicatt.it/handle/10807/303653

UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85164235674&origin=inward

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85164235674&origin=inward

U2 - 10.1007/s00464-023-09998-5

DO - 10.1007/s00464-023-09998-5

M3 - Article

SN - 0930-2794

VL - 37

SP - 5137

EP - 5149

JO - Surgical Endoscopy

JF - Surgical Endoscopy

IS - 7

ER -

Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach

Abstract

All Science Journal Classification (ASJC) codes

Keywords

OSS delle Nazioni Unite

Accesso al documento

Altri file e collegamenti

Fingerprint

Cita questo