Comparative study of laparoscopic and laparotomy surgery for postoperative complications of upper gastrointestinal perforation

Abstract

Objective To analyze and compare the complications of laparotomysurgery and laparoscopic surgery for upper gastrointestinal perforation. Methods Retrospective analyzed the clinical data of 113 patients, including 100 male cases, 13 female cases, aged 17 to 87 years old, mean (51.42 ± 17.11) years old, with perforation in stomach and duodenum at Chinese People′s Liberation Army General Hospital from January 2008 to January 2017. The patients were divided into laparotomy group (64 cases) and laparoscopic group (49 cases) according to the operation mode, and the intraoperative blood loss and postoperative complications were compared. The measurement data were expressed by (±s), and the t test was used between the groups. The count data were expressed by ratio or percentage, the chi-square test was used. Results The amount of bleeding in laparoscopic group was (51.90 ± 18.91) ml, was significantly less than that of laparotomy group (74.60±10.23) ml (χ2=8.186, P=0.000). Postoperative complications occurred in 28 patients (24.8%) in 113 patients, and the top three complications were incision infection, pneumonia, and anastomotic or patch bleeding. The incidence of postoperative complications in laparotomy group and laparoscopic group was 29.7% (19/64) and 18.4% (9/49), respectively, and there was no significant difference (χ2=1.908, P=0.193). Conclusion The two kinds of operation methods of upper digestive tract perforation are similar, and the amount of bleeding in laparoscopic operation group is less than that in laparotomy group, at the same time, higher technical requirements are need to be completed by experienced doctors for minimally invasive surgery. Key words: Postoperative complications; Intestinal perforation; Upper gastrointestinal perforation; Open surgery; Endoscopic surgery