Is it possible to reduce the surgical mortality and morbidity of peptic ulcer perforations?
Adnan Hut1, Cihad Tatar2, Doğan Yıldırım1, Turgut Dönmez3, Akın Ünal1, Ahmet Kocakuşak1, Muzaffer Akıncı1
1Department of General Surgery, Haseki Training and Research Hospital, İstanbul, Turkey
2Department of General Surgery, İstanbul Training and Research Hospital, İstanbul, Turkey
3Department of General Surgery, Lütfiye Nuri Burat State Hospital, İstanbul, Turkey
Keywords: Mortality, perforation, peptic ulcer perforation, risk factors
Objective: Peptic ulcer perforation is a life-threatening situation requiring urgent surgical treatment. A novel vision in peptic ulcer perforation is necessary to fill the gaps created by antiulcer medication, aging of the patients, and presentation of resistant cases in our era. In this study, we aimed to share our findings regarding the effects of various risk factors and operative techniques on the mortality and morbidity of patients with peptic ulcer perforation.
Material and Methods: Data from 112 patients presenting at our Training and Research Hospital Emergency Surgery Department between January 2010 and December 2015 who were diagnosed with PUP through physical examination and laboratory and radiological tests and operated at the hospital have been retrospectively analyzed. Patients were divided into three groups based on morbidity (Group 1), mortality (Group 2), and no complication (Group 3).
Results: Of the 112 patients included in the study, morbidity was observed in 21 (18.8%), mortality in 11 (9.8%), and no complication was observed in 80 (71.4%), who were discharged with cure. The differences between group for the average values of the perforation diameter and American Society of Anesthesiologists, Acute Physiology and Chronic Health Evaluation II, and Mannheim Peritonitis Index scores were statistically significant (p<0.001 for each). The average values for the group with mortality were significantly higher than those of the other groups.
Conclusion: In this study where we investigated risk factors for increased morbidity and mortality in PUPs, there was statistically significant difference between the average values for age, body mass index, perforation diameter, and Acute Physiology and Chronic Health Evaluation II and Mannheim Peritonitis Index scores among the three groups, whereas the amount of subdiaphragmatic free air did not differ.
Cite this paper as: Hut A, Tatar C, Yıldırım D, Dönmez T, Ünal A, Kocakuşak A, et al. Is it possible to reduce the surgical mortality and morbidity of peptic ulcer perforations? Turk J Surg 2017; 33: 267-273.
Ethics committee approval was received for this study from the ethics committee of Haseki Training and Research Hospital.
Written informed consent was obtained from patient who participated in this study.
Concept - A.H., C.T., D.Y.; Design - A.H., C.T.; Supervision - C.T., A.K., M.A.; Resource - A.H., C.T., A.K.; Materials - C.T., D.Y., T.D., A.U.; Data Collection and/or Processing - D.Y., T.D., A.U., A.K., M.A.; Analysis and/or Interpretation - C.T., T.D., A.K., M.A.; Literature Search - C.T., A.U.; Writing Manuscript - A.H., C.T.; Critical Reviews - T.D., A.K., M.A.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.