Laparoscopic versus laparoscopy-assisted suturing of perforated peptic ulcers (meta-analysis)

Panin S.I.; Beburishvili A.G.; Fedorov A.V.; Sazhin I.V.; Mikhin I.V.; Nishnevich E.V.; Levchuk A.L.; Timerbulatov Sh.V.

doi:https://doi.org/10.17116/hirurgia202302172

Panin S.I.

Volgograd State Medical University

SPIN RSCI: 8303-5413
Scopus AuthorID: 57198338379
ORCID: 0000-0003-4086-2054

Beburishvili A.G.

Volgograd State Medical University

Fedorov A.V.

Vishnevsky National Medical Research Center for Surgery;
Russian Society of Surgeons

ORCID: 0000-0002-8456-8685

Sazhin I.V.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-8073-6717

Mikhin I.V.

Volgograd State Medical University

Scopus AuthorID: 6505984534
ResearcherID: C-1627-2016
ORCID: 0000-0002-0104-2822

Nishnevich E.V.

Ural State Medical University

Levchuk A.L.

Pirogov National Medical Surgical Center

Timerbulatov Sh.V.

Bashkir State Medical University

Laparoscopic versus laparoscopy-assisted suturing of perforated peptic ulcers (meta-analysis)

Authors:

Panin S.I., Beburishvili A.G., Fedorov A.V., Sazhin I.V., Mikhin I.V., Nishnevich E.V., Levchuk A.L., Timerbulatov Sh.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2023;(2): 72‑78

DOI: 10.17116/hirurgia202302172

Read: 2823 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Panin SI, Beburishvili AG, Fedorov AV, et al. . Laparoscopic versus laparoscopy-assisted suturing of perforated peptic ulcers (meta-analysis). Pirogov Russian Journal of Surgery. 2023;(2):72‑78. (In Russ.)
https://doi.org/10.17116/hirurgia202302172

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

Close metadata

OBJECTIVE

To compare laparoscopic and laparoscopy-assisted repair of perforated peptic ulcer using evidence-based methods.

MATERIAL AND METHODS

A systematic review and meta-analysis were carried out in accordance with the recommendations of the Ministry of Health of Russian Federation and Cochrane Handbook for Systematic Reviews.

Data searching was carried out in Russian and English languages using the E-library, Cochrane Library and PubMed databases. We analyzed titles and references in specialized journals and thematic reviews, respectively. Clarifying information was obtained via personal contacts with the heads of surgical hospitals. The RevMan 5.4 software was used for statistical analysis.

RESULTS

We found no randomized trials devoted to comparison of laparoscopic and laparoscopy-assisted surgeries in patients with perforated peptic ulcer. Meta-analysis was based on non-randomized trials with satisfactory methodological quality according to the I-ROBINS formalized assessment. Overall clinical material included 478 observations: 229 (47.9%) laparoscopic surgeries and 249 (52.1%) laparoscopy-assisted procedures via minimally invasive access. There were no conversions. Incidence of postoperative complications was 4.36 and 8.83% (OR=0.39, 95% CI 0.08, 1.87), postoperative mortality 0.87 and 0.81%, respectively (OR=1.26, 95% CI 0.08, 8.24). Laparoscopic surgeries were shorter (MD= –8 min, 95% CI –9.7, –6.4). Length of hospital-stay was also shorter after laparoscopic surgery (MD= –4.6, 95% CI –9.7, –6.4).

CONCLUSION

Laparoscopic operations are shorter and accompanied by lower incidence of postoperative complications and less hospital-stay. Large statistical power is required to confirm these differences.

Keywords:

perforated ulcer

laparoscopy

meta-analysis

Authors:

Panin S.I.

Volgograd State Medical University

SPIN RSCI: 8303-5413
Scopus AuthorID: 57198338379
ORCID: 0000-0003-4086-2054

Beburishvili A.G.

Volgograd State Medical University

Fedorov A.V.

Vishnevsky National Medical Research Center for Surgery;
Russian Society of Surgeons

ORCID: 0000-0002-8456-8685

Sazhin I.V.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-8073-6717

Mikhin I.V.

Volgograd State Medical University

Scopus AuthorID: 6505984534
ResearcherID: C-1627-2016
ORCID: 0000-0002-0104-2822

Nishnevich E.V.

Ural State Medical University

Levchuk A.L.

Pirogov National Medical Surgical Center

Timerbulatov Sh.V.

Bashkir State Medical University

Received:

21.09.2022

Accepted:

07.10.2022

Close metadata

References:

Revishvili AS, Olovyanny VE, Sazhin VP, Anishenko MA, Kuznetcov AV, Mironova NL, Shelina NV. Surgical treatment in Russian Federation. Information and analytical collection for 2020. Accessed April 28, 2022. (In Russ.). https://anyflip.com/nvzse/qjoj/
Omel’yanovskii VV. Metodicheskie rekomendatsii po provedeniyu otsenki nauchnoi obosnovannosti vklyuchaemoi v klinicheskie rekomendatsii informatsii. M. 2019. Accessed June 04, 2022. (In Russ.). https://rosmedex.ru/wp-content/uploads/2019/10/mr_nauch-obosn-kr.pdf
Omel’yanovskii VV. Metodicheskie rekomendatsii po provedeniyu meta-analiza. M. 2017. Accessed June 04, 2022. (In Russ.). https://rosmedex.ru/wp-content/uploads/2018/01/Metodicheskie-rekomendatsii-po-provedeniyu-meta-analiza-2017-g..pdf
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane, 2022. Accessed June 04, 2022. www.training.cochrane.org/handbook
Timerbulatov VM, Sibaev VM, Sagitov RB. Terminology and classification of minimally invasive operations. Klinicheskaya i eksperimental’naya khirurgiya. 2011;1:89-99. (In Russ.).
Beburishvili AG, Prudkov MI, Shulutko AM, Natroshvili AG, Panin SI, Nesterov SS, Natroshvili IG. The comparative analysis of laparoscopic and minilaparotomic techniques in emergency abdominal surgery. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N.I. Pirogova. 2013;1:53-57. (In Russ.).
Review Manager. RevMan 5 download and installation. Accessed 04.06.22. https://community.cochrane.org/tools/review-production-tools/revman-5/revman-5-download
Beburishvili AG, Panin SI, Mikhailov DV, Postolov MP. Perforated duodenal ulcer in high risk patients. Khirurgiya. Zhurnal im. NI Pirogova. 2018;11:39-43. (In Russ.). https://doi.org/10.17116/hirurgia201811139
Timerbulatov ShV, Sagitov RB, Smyr RA, Khisamutdinova RI. Minimally invasive surgeries for perforated gastroduodenal ulcers. Endoscopic Surgery. 2017;23(2):8-11. (In Russ.). https://doi.org/10.17116/endoskop20172328-11
Nishnevich EV. The role and place of operations from minilaparotomy access in emergency surgery of the abdominal organs. Vestnik Ural’skoj medicinskoj akademicheskoj nauki. 2009;3(26):109-112. (In Russ.).
Levchuk AL, Abdullaev AE. Comparative characteristics of the results of treatment of patients with perforated gastroduodenal ulcers. Vestnik Nacional’nogo mediko-hirurgicheskogo Centra im. N.I. Pirogova. 2017;4(2):42-46. (In Russ.). https://cyberleninka.ru/article/n/sravnitelnaya-harakteristika-rezultatov-lecheniya-bolnyh-s-perforativnymi-gastroduodenalnymi-yazvami
Mouret P, François Y, Vignal J, Barth X, Lombard-Platet R. Laparoscopic treatment of perforated peptic ulcer. Br J Surg. 1990;77(9):1006. https://doi.org/10.1002/bjs.1800770916
Tarasconi A, Coccolini F, Biffl WL, Tomasoni M, Ansaloni L, Picetti E, Molfino S, Shelat V, Cimbanassi S, Weber DG, Abu-Zidan FM, Campanile FC, Di Saverio S, Baiocchi GL, Casella C, Kelly MD, Kirkpatrick AW, Leppaniemi A, Moore EE, Peitzman A, Fraga GP, Ceresoli M, Maier RV, Wani I, Pattonieri V, Perrone G, Velmahos G, Sugrue M, Sartelli M, Kluger Y, Catena F. Perforated and bleeding peptic ulcer: WSES guidelines. World J Emerg Surg. 2020;7:15:3. https://doi.org/10.1186/s13017-019-0283-9
Cirocchi R, Soreide K, Di Saverio S, Rossi E, Arezzo A, Zago M, Abraha I, Vettoretto N, Chiarugi M. Meta-analysis of perioperative outcomes of acute laparoscopic versus open repair of perforated gastroduodenal ulcers. J Trauma Acute Care Surg. 2018;85(2):417-425. https://doi.org/10.1097/TA.0000000000001925
Lau WY, Leung KL, Kwong KH, Davey IC, Robertson C, Dawson JJ, Chung SC, Li AK. A randomized study comparing laparoscopic versus open repair of perforated peptic ulcer using suture or sutureless technique. Ann Surg. 1996;224(2):131-138. https://doi.org/10.1097/00000658-199608000-00004.
Joshi MA, Gadhire M, Paranjpe AA. Treatment of duodenal peptic ulcer perforation by endoscopic clips: A novel approach. J Dig Endosc. 2017;8:24.
Bergstrom M, Arroyo Vazquez JA, Park PO. Self-expandable metal stents as a new treatment option for perforated duodenal ulcer. Endoscopy. 2013;45:222-225. https://doi.org/10.1055/s-0032-1325885
Prudkov ID, Khodakov VV, Prudkov MI. Ocherki laparoskopicheskoj khirurgii. Sverdlovsk: Izd-vo Ural. un-ta; 1989. (In Russ.).
Shulutko AM, Danilov AI. Combined technique for suturing perforated duodenal ulcers. Endoscopic Surgery. 1999;1:79. (In Russ.).
Sazhin VP, Zhabolenko VP, Sazhin AV. The role of laparoscopic vagotomy in the complex treatment of duodenal ulcer. Sbornik nauchnykh trudov. K 50-letiyu kafedry gospital’noi khirurgii Ryazanskogo gosudarstvennogo meditsinskogo universiteta im. akad. I.P. Pavlova. Ryazan’. 2002:78-90. (In Russ.).