A prospective observational study on feasibility of laparoscopic perforation repair in patients presenting with intestinal perforation at a tertiary care superspeciality hospital in Chhattisgarh

Authors

  • Deepak Taneja Department of Minimal Access Surgery, Care Hospital, Raipur, Chhattisgarh, India
  • Akash Gupta Department of Minimal Access Surgery, Care Hospital, Raipur, Chhattisgarh, India
  • Sandeep Dave Department of Minimal Access Surgery, Care Hospital, Raipur, Chhattisgarh, India
  • Siddharth Tamaskar Department of Minimal Access Surgery, Care Hospital, Raipur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20201876

Keywords:

Bowel perforation, Feasibility, Laparoscopic repair

Abstract

Background: Bowel perforation is one of the common emergencies faced by the surgeons in the developing world. It carries a high morbidity and mortality rate even today. In the present era, laparoscopy is being used as a better treatment alternative across the world. Various reports in literature are now available regarding the feasibility of laparoscopic repair of bowel perforation. The purpose of this study was to assess the feasibility of laparoscopic primary suture repair as the initial modality in treating a bowel perforation and to analyze the pattern of bowel perforation in relation to age, sex and etiology in Chhattisgarh state.

Methods: This study included the data of relevant patients who got admitted in Ramkrishna Care Hospital Raipur from 1st October 2017 to 31st September 2019 (24 months).

Results: Most commonly affected mean age group in this study was 39±15.82 years with male predominance. Statistically  significant findings in favour of laparoscopic repair in our study were early return of bowel activity, less incidence of surgical site infection, early return to work (less hospital stay), less post-operative pain as compared to open surgery (p<0.05).

Conclusions: In this study it was found that laparoscopy in patients with bowel perforation who are hemodynamically stable and present early (<72 hours) to the hospital is feasible and safe and gives many benefits including reduction in perioperative morbidity and mortality. 

References

Langell JT, Mulvihill SJ. Gastrointestinal perforation and the acute abdomen. Med Clin North Am. 2008;92(3):599-625.

Cahalane MJ. Overview of gastrointestinal tract perforation. UpToDate. 2017.

Hill AG. Management of perforated duodenal ulcer. In Holzhemer RG, Mannick JA, editors. Surgical treatment: evidence based andproblem oriented. Munich: Zuckschwerdt; 2001.

Sinha R, Sharma N, Joshi M. Laparoscopic repair of small bowel perforation. JSLS. 2005;9(4):399-402.

Patel J, Patel P. Laparoscopic approach for small - bowel perforation - early outcome for 20 patients. 2016;3(4):2191-5.

Kidwai R, Ansari MA. Graham patch versus modified graham patch in the management of perforated duodenal ulcer. J Nepalgunj Med Coll. 2017;13(1):28-31.

Agrusa A, Buono GD, Buscemi S, Cucinella G, Romano G, Gulotta G. 3D laparoscopic surgery : a prospective clinical trial. Oncotarget. 2018;9(25):17325-33.

Nazari S, Khosroshahi S, Khedmat H, Azhie F. Repair of iatrogenic large colon perforation using laparoscopic methods, case report and review of the literature. Middle East J Dig Dis. 2010;2(2):110-5.

Hsu YS, Chen H, Lin T. Laparoscopic primary repair of iatrogenic colon perforation. J Soc Colon Surgeon. 2010;3:29-36.

Husain M, Khan R, Rehmani B, Haris H. Omental patch technique for the ileal perforation secondary to typhoid fever. Saudi J Gastroenterol. 2011;17(3):208.

Addeo P, Calabrese DP. Diagnostic and therapeutic value of laparoscopy for small bowel blunt injuries: a case report. Int J Surg Case Rep. 2011;2(8):316-8.

Sangrasi AK. Role of laparoscopy in peritonitis. Pak J Med Sci. 2013;29(4):1028-32.

Chakma SM, Singh RL, Parmekar MV, Gojen Singh KH, Kapa B, et al. Spectrum of perforation peritonitis. J Clin Diagnostic Res. 2013;7(11):2518-20.

Abdelaziem S, Hashish MS, Suliman AN, Sargsyan D. Laparoscopic repair of perforated duodenal ulcer (series of 50 cases). Surg Sci. 2015;6(2):80-90.

Sorensen SMD, Savran MM, Konge L, Bjerrum F. Three-dimensional versus two-dimensional vision in laparoscopy: a systematic review. Surg Endosc. 2016;30(1):11-23.

Sharma P, Jhanwar A, Mehta F. Laparoscopic peptic perforation repair: our experience at rural tertiary care center. Int Surg J. 2016;3(3):1534–7.

Anbalakan K, Chua D, Pandya GJ, Shelat VG. Five year experience in management of perforated peptic ulcer and validation of common mortality risk prediction models - Are existing models sufficient? A retrospective cohort study. Int J Surg. 2015;14:38–44.

Wilhelmsen M, Møller MH, Rosenstock S. Surgical complications after open and laparoscopic surgery for perforated peptic ulcer in a nationwide cohort. Br J Surg. 2015;102(4).

Ramachandran CS, Agarwal S, Goel D, Arora V. Laparoscopic surgical management of perforative peritonitis in enteric fever: A preliminary study. Surg Laparosc Endosc Percutaneous Tech. 2004;14(3):122–4.

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Published

2020-04-23

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Original Research Articles