Evidence map›Paper›PMID 29998395›Full record

ArticleSurgical endoscopy2019

A comparison of short-term outcomes between laparoscopic and open emergent repair of perforated peptic ulcers.

Daniel L Davenport, Walker R Ueland, Shyanie Kumar, Margaret Plymale, Andrew C Bernard, J Scott Roth

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Daniel L DavenportDepartment of Surgery, University of Kentucky, 800 Rose Street, MN274, Lexington, KY, 40536-0298, USA. daniel.davenport@uky.edu.
Walker R UelandCollege of Medicine, University of Kentucky, Lexington, KY, USA.
Shyanie KumarGeneral Surgery Residency Program, University of Kentucky, Lexington, KY, USA.
Margaret PlymaleDepartment of Surgery, University of Kentucky, 800 Rose Street, MN274, Lexington, KY, 40536-0298, USA.
Andrew C BernardDepartment of Surgery, University of Kentucky, 800 Rose Street, MN274, Lexington, KY, 40536-0298, USA.
J Scott RothDepartment of Surgery, University of Kentucky, 800 Rose Street, MN274, Lexington, KY, 40536-0298, USA.
University of Kentucky · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe compared 30-day outcomes in patients undergoing emergent open and laparoscopic repair of perforated peptic ulcers in a large multicenter cohort.

methodsProspectively obtained data in the American College of Surgeons National Surgical Quality Improvement Program public use files from 2010 to 2016 were reviewed. Perioperative risks and outcomes were compared in unmatched and propensity-matched groups using parametric/non-parametric statistical tests as appropriate.

resultsA total of 4210 procedures were identified 345 (8.2%) laparoscopic and 3865 (91.8%) open. Laparoscopic repairs increased from 4.5% of 2010 cases to 11.4% of 2016 cases (p < .001). Open repair patients had more acute presentation including higher rates of ASA class, hypoalbuminemia, preoperative septic shock, dyspnea, and mechanical ventilation (all p < .01). Laparoscopic operations were longer than open procedures (p < .001). Mortality (8.5 vs. 3.5%), median length of stay (7 vs. 5 days), transfusion rates (13.7 vs. 7.0%), renal failure (3.7 vs. 1.2%), and respiratory failure (15.5 vs. 5.2%) were all worse in the unmatched open group (all p < .01). Propensity matching resulted in 342 laparoscopic and 626 open cases of similar ulcer type, demographics, ASA class, preoperative SIRS/sepsis, hypoalbuminemia, and wound class. Mortality was similar between matched groups (5.0 vs. 3.5%, p = .331). Median length of stay was longer in the open group (6 vs. 5 days, p < .001), which also had higher rates of prolonged ventilation/reintubation (9.6 vs. 5.3%, p = .019) and abdominal wall wound occurrences (6.2 vs. 2.3%, p = .042). Return to the operating room and 30-day readmissions did not differ between the matched groups.

conclusionsEmergent laparoscopic repair of perforated peptic ulcer is increasingly being performed, is safe relative to open repair (in patients without preoperative septic shock), and confers a modest benefit in terms of length of stay, respiratory, and abdominal wall wound complications.

Indexed as

LaparoscopyAdultAgedEmergenciesFemaleFollow-Up StudiesHumansLength of StayMaleMatched-Pair AnalysisMiddle AgedPatient ReadmissionPeptic Ulcer PerforationPostoperative ComplicationsPropensity ScoreQuality ImprovementLaparoscopic repairOpen repairOutcomesPerforated peptic ulcer

Identifiers

PMID29998395
OpenAlexW2848006965

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.