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Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial

BACKGROUND: Peptic ulcer perforation is a common life-threatening surgical emergency. Graham omental patch is performed for plugging of perforated peptic ulcer. Many endoscopic methods have been used to treat acute perforated peptic ulcer such as over the scope clips, standard endoscopic clips, endo...

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Autores principales: Negm, Said, Mohamed, Hatem, Shafiq, Ahmed, AbdelKader, Taha, Ismail, Adel, Yassin, Mahmoud, Mousa, Bassam, Abozaid, Mohamed, Orban, Yasser A., Al Alawi, Mazoun, Farag, Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131571/
https://www.ncbi.nlm.nih.gov/pubmed/35610657
http://dx.doi.org/10.1186/s13017-022-00429-9
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author Negm, Said
Mohamed, Hatem
Shafiq, Ahmed
AbdelKader, Taha
Ismail, Adel
Yassin, Mahmoud
Mousa, Bassam
Abozaid, Mohamed
Orban, Yasser A.
Al Alawi, Mazoun
Farag, Ahmed
author_facet Negm, Said
Mohamed, Hatem
Shafiq, Ahmed
AbdelKader, Taha
Ismail, Adel
Yassin, Mahmoud
Mousa, Bassam
Abozaid, Mohamed
Orban, Yasser A.
Al Alawi, Mazoun
Farag, Ahmed
author_sort Negm, Said
collection PubMed
description BACKGROUND: Peptic ulcer perforation is a common life-threatening surgical emergency. Graham omental patch is performed for plugging of perforated peptic ulcer. Many endoscopic methods have been used to treat acute perforated peptic ulcer such as over the scope clips, standard endoscopic clips, endoscopic sewing and metallic stents. The main idea in endoscopic management of acute perforated peptic ulcer is early decontamination and decrease sepsis by interventional radiologic drainage. METHODS: This is a prospective randomized controlled clinical trial. This study included patients who were developed acute perforated peptic ulcer manifestations and were admitted to our hospital between December 2019 and August 2021. Sample size was 100 patients divided into 2 equal groups. Endoscopic group (EG): included 50 patients who were subjected to endoscopic management. Surgical group (SG): included 50 patients who were subjected to surgical management. RESULTS: One hundred patients were randomized into 2 groups: SG (50) and EG (50). Median age of patients was 36 (range 27:54) and 47 (range 41:50) years-old in SG and EG, respectively. Males constituted 72% and 66% in SG and EG, respectively. Median length of postoperative hospital stay was 1 (range: 1–2) days in EG, while in SG was 7 (range 6–8) days. Postoperative complications in SG patients were 58% in form of fever, pneumonia, leak, abdominal abscess, renal failure and incisional hernia (11%, 5%, 5%, 3%, 2% and 3%, respectively). Postoperative complications in EG patients were 24% in form of fever, pneumonia, leak, abdominal abscess, renal failure and incisional hernia (10%, 0%, 2%, 0%, 0% and 0%, respectively). CONCLUSION: Combined endoscopic and interventional radiological drainage can effectively manage acute perforated peptic ulcer without the need for general anesthesia, with short operative time, in high risk surgical patients with low incidence of morbidity & mortality.
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spelling pubmed-91315712022-05-26 Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial Negm, Said Mohamed, Hatem Shafiq, Ahmed AbdelKader, Taha Ismail, Adel Yassin, Mahmoud Mousa, Bassam Abozaid, Mohamed Orban, Yasser A. Al Alawi, Mazoun Farag, Ahmed World J Emerg Surg Research BACKGROUND: Peptic ulcer perforation is a common life-threatening surgical emergency. Graham omental patch is performed for plugging of perforated peptic ulcer. Many endoscopic methods have been used to treat acute perforated peptic ulcer such as over the scope clips, standard endoscopic clips, endoscopic sewing and metallic stents. The main idea in endoscopic management of acute perforated peptic ulcer is early decontamination and decrease sepsis by interventional radiologic drainage. METHODS: This is a prospective randomized controlled clinical trial. This study included patients who were developed acute perforated peptic ulcer manifestations and were admitted to our hospital between December 2019 and August 2021. Sample size was 100 patients divided into 2 equal groups. Endoscopic group (EG): included 50 patients who were subjected to endoscopic management. Surgical group (SG): included 50 patients who were subjected to surgical management. RESULTS: One hundred patients were randomized into 2 groups: SG (50) and EG (50). Median age of patients was 36 (range 27:54) and 47 (range 41:50) years-old in SG and EG, respectively. Males constituted 72% and 66% in SG and EG, respectively. Median length of postoperative hospital stay was 1 (range: 1–2) days in EG, while in SG was 7 (range 6–8) days. Postoperative complications in SG patients were 58% in form of fever, pneumonia, leak, abdominal abscess, renal failure and incisional hernia (11%, 5%, 5%, 3%, 2% and 3%, respectively). Postoperative complications in EG patients were 24% in form of fever, pneumonia, leak, abdominal abscess, renal failure and incisional hernia (10%, 0%, 2%, 0%, 0% and 0%, respectively). CONCLUSION: Combined endoscopic and interventional radiological drainage can effectively manage acute perforated peptic ulcer without the need for general anesthesia, with short operative time, in high risk surgical patients with low incidence of morbidity & mortality. BioMed Central 2022-05-24 /pmc/articles/PMC9131571/ /pubmed/35610657 http://dx.doi.org/10.1186/s13017-022-00429-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Negm, Said
Mohamed, Hatem
Shafiq, Ahmed
AbdelKader, Taha
Ismail, Adel
Yassin, Mahmoud
Mousa, Bassam
Abozaid, Mohamed
Orban, Yasser A.
Al Alawi, Mazoun
Farag, Ahmed
Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial
title Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial
title_full Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial
title_fullStr Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial
title_full_unstemmed Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial
title_short Combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial
title_sort combined endoscopic and radiologic intervention for management of acute perforated peptic ulcer: a randomized controlled trial
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131571/
https://www.ncbi.nlm.nih.gov/pubmed/35610657
http://dx.doi.org/10.1186/s13017-022-00429-9
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