Laparoscopic And Open Abdominal Repair Of Upper Gastrointestinal Perforation

Objective: To compare the advantages and disadvantages of laparoscopic and traditional laparotomy in upper gastrointestinal perforation to provide basis for clinical choice of surgical methods.Methods: A retrospective analysis of the my Hospital from December 2015 to January 2018 emergency department of upper gastrointestinal perforation repair 92 cases of relevant information,were randomly divided into two groups,namely laparoscopic group and open group,Including 47 cases of traditional laparotomy and 45 cases of laparoscopy.The patients' gender,age,onset time,operation time,intraperitoneal pus volume,incision length,postoperative anal exhaust time,hospitalization time and so on were compared between the two methods.Common postoperative complications(lung infection,intestinal obstruction,intestinal fistula,perforation infection or incision infection,abdominal abscess,etc.)incidence.Results: The average length of surgical incision in laparoscopic group and open group was 2.32 ± 0.62 cm.The average length of surgical incision in open group was 6.49 ± 1.55 cm.The length of surgical incision in laparoscopic group was significantly shorter than that in open group.There was significant difference between the two groups There was statistical significance(P <0.05).The mean value of hemorrhage in laparoscopic group was 31.66 ± 10.53 ml,and the mean amount of bleeding in open group was 46.35 ± 13.40 ml,which was significantly higher in laparotomy group than in laparoscopic group(P <0.05)).The average time for getting out of bed in laparoscopic group was 2.16 ± 0.95 days,and the mean time for getting out of bed in open group was 2.97 ± 0.64 days.Compared with the time of going to bed in laparoscopic group,Early,the difference between the two groups was statistically significant(P <0.05).The average time of anus ventilation in laparoscopic group was 2.09 ± 0.53 days,and the average time of anal ventilation in open group was 2.77 ± 0.66 days.The time of anus ventilation in both groups was shorter than that in laparoscopic group,The difference was statistically significant(P <0.05).The average length of hospital stay in laparoscopic group was 6.86 ± 1.96 days,and the mean length of hospital stay in open group was 8.91 ± 2.15 days.Comparing the time of anal ventilation in both groups,laparoscopic group had earlier hospitalization than open group,there was significant difference between the two groups Statistical significance(P <0.05).The total number of complications after laparoscopic surgery was 3 cases(6.7%).The total number of complications after laparotomy was 8 cases(17.0%).The total postoperative complications rate The abdominal group was higher than the laparoscopic group,the difference between the two groups was statistically significant(P <0.05).The differences of sex,age,course of disease,preoperative WBC,N counts,perforation,peritoneal effusion,incision or Trocar hole infection,pulmonary infection,abdominal abscess,intestinal obstruction and repair fistula in laparoscopic group and open group No statistical significance(P> 0.05).Conclusion: Compared with the open group,the laparoscopic group has the advantages of less trauma,faster recovery,less postoperative complications and shorter hospital stay.In the treatment of upper gastrointestinal perforation,laparoscopic upper gastrointestinal perforation repair may be a A safe and effective method of surgery.