Long-term results of minimally invasive laparoscopic surgery and open suturing of perforated duodenal ulcers
There were analyzed the results of surgical treatment of 351 patients operated on for perforated duodenal ulcer with the help of traditional palliative techniques, and 20 patients - with a minimally invasive technique. There was conducted the comparison of long-term results of surgical treatment of 167 patients, who underwent conventional palliative surgery, and 20 patients, who underwent laparoscopic surgery. In the control group, the patients who underwent “simple” suturing had only “unsatisfactory” results (100%); in the main group after palliative intervention, Visick I was observed in 73 (45.1%) patients, Visick II - in 57 (35.8%) patients, Visick III - in 16 (9.9%) patients, and Visick IV - in 15 (9.3%) patients (p<0.0001). Laparoscopic surgery provides the best long-term results if compared with the surgeries of the “simple” repair for perforated ulcer that were conducted in 23 patients. In the control group, the rate of recurrence of ulcers after traditional suturing was 100%, in the main group it was 55%, in the group of minimally invasive procedures it decreased to 10% or by 10 and 5.5 times (p=0.0055 and p=0.0069, respectively). In the group of minimally invasive techniques there was observed the predominance of “excellent” and “good” results (60%) over “satisfactory” and “unsatisfactory” ones (40%, p=0.3428). Minimally invasive interventions are not inferior to traditional techniques. However, patients need half the duration of use of pain medication, and bed-day is reduced by 2.7 times (p<0.0001), followed by faster social rehabilitation of patients and better indicators of physical and psychological health.