Meta-analysis Of Laparoscopic Versus Open Repair Of Perforated Peptic Ulcer

Objective:To study the safety and efficacy of laparoscopy and open repair for patients with perforated peptic ulcer.Method:Articles published in Chinese and English were searched in the Cochrane Library and on the databases of Pub Med, EMBASE,CNKI, Wanfang from January 1990 and September 2014,to meet the searching requirements. Meta-analysis was used to analyze the collected data.The English retrieval strategy:(laparoscopic repair)AND(perforated peptic ulcer).According to the literature of the inclusion and exclusion criteria, extracted by two graduate students independently related data of included literature, if differences resolved by discussion or by third decided.Meta analysis of clinical data with Rev Man 5.2.7software; using Rev Man 5.2.7 software on the heterogeneity test, according to the results of the heterogeneity of choice for fixed or random effects models. Publication bias is represented by funnel plot.Result:The data of 6 randomized clinical trials of acceptable quality were collected from the databases,including a total of 682 cases of patients,362 cases of laparoscopic group,320 cases of open group.The results showed that no statistically significant differences between laparoscopic and open surgery in the operative time(P=0.37),intra-abdominal abscess(P =0.57)and mortality(P=0.34).Conclusions:Compared with open operation in treatment of peptic ulcer perforation, laparoscopic operation, less bleeding, less trauma, faster postoperative recovery, the main postoperative complication rate is low, is a safe and feasible treatment method.But because of the quality of the included studies is not high and the small sample, multi center clinical RCTs this conclusion still needs to design better, large quantity, high quality, to provide evidence for better.