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Panin S.I.

Volgograd State Medical University

Suvorov V.A.

Volgograd Regional Clinical Oncologic Dispensary

Kovalenko N.V.

Volgograd State Medical University;
Volgograd Regional Clinical Oncology Dispensary

Bykov A.V.

Volgograd State Medical University

Postolov M.P.

Volgograd State Medical University;
Volgograd Regional Clinical Oncology Dispensary

Linchenko A.M.

Volgograd State Medical University

Kosivtsov O.A.

Volgograd State Medical University

Mikhin E.S.

Volgograd State Medical University

Perforated peptic ulcer in patients with cancer: prediction of postoperative morbidity and mortality

Authors:

Panin S.I., Suvorov V.A., Kovalenko N.V., Bykov A.V., Postolov M.P., Linchenko A.M., Kosivtsov O.A., Mikhin E.S.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2022;(7): 12‑18

DOI: 10.17116/hirurgia202207112

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Table of contents

PERFORATED PEPTIC ULCER IN PATIENTS WITH CANCER: PREDICTION OF POSTOPERATIVE MORBIDITY AND MORTALITY
PERFORATED PEPTIC ULCER IN PATIENTS WITH CANCER: PREDICTION OF POSTOPERATIVE MORBIDITY AND MORTALITY

To cite this article:

Panin SI, Suvorov VA, Kovalenko NV, et al. . Perforated peptic ulcer in patients with cancer: prediction of postoperative morbidity and mortality. Pirogov Russian Journal of Surgery. 2022;(7):12‑18. (In Russ.)
https://doi.org/10.17116/hirurgia202207112

Подписка 2025-2 (Pirogov Russian Journal of Surgery)
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OBJECTIVE

To analyze treatment outcomes and approaches to predicting the postoperative morbidity and mortality in patients with perforated ulcers and cancer.

MATERIAL AND METHODS

A non-randomized trial included 194 patients. The first group enrolled 45 (23%) patients with perforated ulcers and concomitant cancer who underwent at the oncology center; the second group included 149 (77%) patients with perforated ulcers and no cancer who underwent surgery in general surgical hospitals. Organ-sparing procedures prevailed (40 (88.9%) and 138 (92.6%) cases, respectively). Resections were performed in 5 (11.1%) and 11 (7.4%) patients respectively. Analyzing the factors affecting treatment outcomes, we studied crude (COR) and adjusted (AOR) odds ratios. ROC-analysis was used to assess diagnostic significance of the models for prognosis of morbidity and mortality.

RESULTS

Length of hospital-stay was 10 (range 9—14) and 8 (range 7—9) days respectively. Postoperative complications (Clavien—Dindo grading system) occurred in 18 (40%) in 37 (24.8%) patients, respectively. According to multivariate analysis, predictors of complications in patients of the first group were treatment with NSAIDs/glucocorticoids and Charlson-Deyo index >3. Sensitivity of this model was 82.4%, specificity — 75.0%. Postoperative mortality was 15.6% (n=7) and 7.4% (n=11) respectively. According to multivariate analysis, predictors of mortality were age over 65 years and more than 5 chemotherapeutic courses. Sensitivity of the model was 85.7%, specificity — 97.4%.

CONCLUSION

The stratified approach makes it possible to improve prediction of postoperative morbidity and mortality in patients with perforated ulcers.

Keywords:

perforated peptic ulcer
prognostic model
mortality
cancer patients

Authors:

Panin S.I.

Volgograd State Medical University

Suvorov V.A.

Volgograd Regional Clinical Oncologic Dispensary

Kovalenko N.V.

Volgograd State Medical University;
Volgograd Regional Clinical Oncology Dispensary

Bykov A.V.

Volgograd State Medical University

Postolov M.P.

Volgograd State Medical University;
Volgograd Regional Clinical Oncology Dispensary

Linchenko A.M.

Volgograd State Medical University

Kosivtsov O.A.

Volgograd State Medical University

Mikhin E.S.

Volgograd State Medical University

Received:

15.02.2022

Accepted:

10.03.2022

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