Comparision of an Upper Gastrointestinal Perforation Surgery by between the Laparoscopic and Open Surgery Approaches

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  • Sasaki Takahiro
    Digestive Disease Center, Toyoko Hospital, St. Marianna University School of Medicine
  • Furuhata Tomohisa
    Digestive Disease Center, Toyoko Hospital, St. Marianna University School of Medicine
  • Usui Sota
    Digestive Disease Center, Toyoko Hospital, St. Marianna University School of Medicine
  • Ono Tatsunori
    Digestive Disease Center, Toyoko Hospital, St. Marianna University School of Medicine
  • Noda Akiyoshi
    Digestive Disease Center, Toyoko Hospital, St. Marianna University School of Medicine
  • Miyajima Nobuyoshi
    Digestive Disease Center, Toyoko Hospital, St. Marianna University School of Medicine
  • Otsubo Takehito
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine

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  • 上部消化管穿孔に対する手術方法の比較検討—聖マリアンナ医科大学東横病院における腹腔鏡下手術と開腹手術の比較での問題点—

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<p>Purpose: We compared laparoscopic and open surgical approaches in upper gastrointestinal tract perforation surgery in our hospital and examined the problems.<br/>Patients and Methods: Surgical factors were examined in 44 patients who underwent surgery for upper gastrointestinal perforation from September 2008 to August 2018, including 38 undergoing laparoscopic surgery (Lap group) and 6 undergoing laparotomy (Open group).<br/>Results: Mean patient age in the Open group was significantly higher at 76.8 (42–91) years (P=0.001), and significantly more patients (n=4) had a history of large laparotomy (P=0.0005). There were no significant between-group differences in operation time, amount of bleeding, postoperative length of hospital stay, and complications. The wash volume during operation was significantly less in the Lap group 5,060 (2,000–20,000) mL (P<0.001). A technically certified surgeon participated significantly more frequently (all 38 cases) in the Lap group (P=0.001). However, among the 6 patients in the Open group, even if they were not elderly, did not require advanced surgery, or had no history of surgery, some underwent laparotomy because of the absence a certified laparoscopic surgeon.<br/>Conclusions: Open surgery was often selected for elderly patients with a history of large open surgery, but in the future, less-invasive laparoscopic surgery will be performed on patients in good general condition.</p>

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