The Effect Of Laparoscopic And Laparotomic Surgery On Post-Op Mortality And Morbidity In The Repair Of Peptic Ulcer Perforation

INTRODUCTION: Our aim is to examine the signifance of laparotomic repair (OR) and laparoscopic repair (LR) on postoperative morbidity and mortality in peptic ulcer perforation (PUP) surgery, to explore the postoperative complications, and to determine the effectiveness of LR.
METHODS: Patients operated for PUP in our hospital between January 2015, and December 2022, were evaluated retrospectively. Gastric perforations from stab wounds and blunt traumas, patients with diseases for which LR is contraindicated, patients with repeated abdominal surgery, and pregnant patients were excluded from the study. 142 patients were included in the research including 37 patients who underwent LR for PUP and 105 patients who underwent OR. Patients were grouped as LR and OR. Infective parameter values, demographic characteristics, postoperative hospital stay, presence of surgical site infection, reoperation, and additional complications of all patients were examined before and after the operation.

RESULTS: The rate of postoperative decrease in leukocyte count was significantly higher in the LR group (p<0.05). Postoperative hospital stay and surgical site infection were lower in the LR group (p<0.05). Although there were no patients in the LR group who were reoperated due to postoperative leakage, the rate was 1.9% in the OR group, although the differences was not significant (p>0.05). The development of postoperative atelectasis was found to be significantly higher in patients who underwent OR (p<0.05).
DISCUSSION AND CONCLUSION: Our data suggests that the LR method can be safely performed in suitable patients as the postoperative morbidity and mortality rates are lower in laparoscopic surgical repair compared with OR.