Comparison of Closure of Gastric Perforation Ulcers With Biodegradable Lactide-Glycolide-Caprolactone or Omental Patches

Bertleff, M. J. O. E.; Stegmann, Toon; Liem, Rsb; Kors, Geert; Robinson, P.H.; Nicolai, Jean Philippe; Lange, Johan F.

doi:10.4293/108680809x12589998404362

Cited by 14 publications

(17 citation statements)

References 15 publications

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“…The application of this patch avoids suturing of friable edges of peptic perforation, thus saving valuable operative time. 14 Conservative treatment of peptic perforation can be done in selected cases with prolonged hospital stay and high mortality rate if conservative treatment fails. Misdiagnosis of gastric carcinoma is likely if surgical treatment is not opted.…”

Section: Discussionmentioning

confidence: 99%

Modified Graham’s repair for peptic ulcer perforation: reassessment study

Arora

2017

Int Surg J

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Background: Peptic perforation is an emergency and requires urgent surgical treatment. Many modalities of treatment are available ranging from conservative treatment to laparoscopic repair. There is no consensus on treatment of perforated pylorodudenal ulcer which can be treated with conservative treatment, simple closure of ulcer, closure of ulcer with free omentum, closure of perforation with use of pedicled omentum, definitive treatment with truncal vagotomy and drainage procedures or parietal cell vagotomy. However best treatment is still to be decided.Methods: This study was conducted in department of surgery 60 patients presenting with peptic perforation in last three years. All patients with duodenal perforation in first part (D1) were included in the study. Pyloric perforations, multiple perforations, traumatic perforations and severe co-morbid condition were excluded from study. A pedicled omentum was used in the repair of duodenal perforation. Immediate and late postoperative complications were recorded. The patients were followed for three months.Results: Out of 60 cases there were 50 male patients and 10 female patients. The majority of male patients were in the middle age group between 35 to 45 years of age and the female patients were of older age group between 40 to 65 years of age. These patients presented with history of acute pain abdomen in the epigastric region. All the patients underwent modified Graham’s patch repair. In postoperative period, two patients had burst abdomen on fourth postoperative day. Biliary fistula formation occurred in 2 patients. Wound infection occurred in 4 patients and the hospital stay was 5 to 9 days. There was no mortality recorded in this series.Conclusions: In summary, the surgery for perforated peptic ulcer should use modified Graham’s repair using pedicled omentum giving excellent results in terms of healing, morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Modified Graham’s repair for peptic ulcer perforation: reassessment study

Arora

2017

Int Surg J

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“…16,17 In these circumstances, gastric resection, partial resection of the stomach with gastrounostomy or insertion of a T-like drainage should be conducted if the defect is located in the duodenum. 18 In recent years, to treat PGDU the endoscopic application of clips or stenting, 19,20 the use of biodegradable material to close the defect in the ulcer site, 21 mesenchymal stem cells to improve healing have been proposed. [22][23][24][25][26][27]…”

Section: Resultsmentioning

confidence: 99%

Perforated gastric and duodenal ulcers: treatment options

Тимербулатов¹,

Тимербулатов²,

Khisamutdinova³

et al. 2018

IPMRJ

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This paper focuses on a prospective nonrandomized review of patients undergoing surgery for perforated gastric and duodenal ulcers. Patients and methods: A total of 198 patients with perforated gastric and duodenal ulcers were enrolled in the study between 2011 and 2016. The mean age of patients was 42 years. The disease was more common in men (87.3%) than in women (12.6%). The incidence of duodenal ulcer perforation was 86.3%. Anti-helicobacter therapy was administered to 33.8% of patients before perforation. In 5.6% of cases, recurrent ulcer perforation was established. The majority of patients (78.8 %) were admitted within the first 12 hours, while 7.5%-24 hours after perforation. The APACHE II scoring system was used to measure shock in 5.5% of cases. A score up to 6 was determined in 37.8% of patients, up to 12-in 47.9%, higher scores (more than 12) were measured in the remaining patients. Physical examination and diagnosis included clinical methods, abdominal X-ray, gastroduodenoscopy, ultrasound, laparoscopy, and the Boey risk scores. Results: Diagnostic laparoscopy was performed in 79.3% of patients, the diagnosis of concealed perforation was confirmed by gastroduodenoscopy. Video-assisted laparoscopy was performed in 59% of patients, 14.7%-underwent combined minimally invasive surgery (abdominal laparascopic examination and surgical intervention in the stomach or duodenum using a minimally invasive technique) and 26.3%-via laparotomy. Laparoscopic surgery was possible on the basis of gastroduodenoscopy, laparoscopy (perforation diameter, a correlation between the size of ulcer and perforation diameter, periulcerous infiltration sizes). Postoperative complications were recorded in 8.1% of cases, the mortality rate was 4.5%.

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“…19,20 A self-expandable metallic vascular occluder has been used successfully experimentally for closure of an access viscerotomy. 21 A biointegrative and absorbable material can avoid a permanent and potentially contaminated foreign body, which may impair healing.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies have used an omentum patch substitute for treating an iatrogenic gastric perforation in 12 dogs (endoscopically) 19 and in 10 rats (surgically). 20 The former used a 4 ϫ 6 -cm piece of bioabsorbable polyglycolic acid mesh, and the latter used a glued biodegradable (lactide-glycolide-caprolactam) patch. In both studies, the mesh repair was feasible, safe, and provided healing in all tested animals.…”

Section: Discussionmentioning

confidence: 99%