Laparoscopic Versus Open Repair of Peptic Ulcer Perforation

NCT ID: NCT04447170

Last Updated: 2021-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-01-01

Study Completion Date

2022-04-01

Brief Summary

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Although laparoscopic repair (LR) of perforated peptic ulcers (PPUs) has long been accepted, clinical evidence comparing LR versus open repair (OR) remains lacking. The aim of this study is to evaluate the feasibility, safety and outcome of laparoscopic gastric repair and compare it with the outcome open repair by relying on a propensity score matching statistical technique

Detailed Description

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Despite the evolution of medical management of Gastroduodenal Peptic Ulcer (GPU), complications like bleeding and perforation are still not uncommon in clinical practice. According to the literature in average, 2-14% of peptic ulcers result in perforation, most 215 commonly occurring in females over the age of 60 and chronic NSAID, alcohol or tobacco users.

Management of perforated peptic ulcer entails resuscitation, pharmacotherapy and surgery.

Traditionally, suture with or without omental patch has been considered the 'gold standard' and still is. It is associated with shorter length of stay, lower transfusion needs and has lower morbidity as compared to gastrectomy. In 1992, it has been proposed that laparoscopy should be routinely considered in the management of perforated duodenal ulcer. Nowadays due to the advances in laparoscopic technique, many publications suggest that laparoscopic repair of perforated peptic ulcers could be a superior choice to open repair. These is linked with the advantages of laparoscopic surgery over open surgery such as reduced postoperative pain, lower wound infection rate, decreased length of hospital stay, and earlier functional recovery

Conditions

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Surgery Emergencies Peptic Ulcer Perforation

Keywords

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Peptic ulcer perforation Laparoscopy

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

OTHER

Study Groups

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Laparoscopic repair

Patients undergoing laparoscopic treatment

Simple repair or Graham technique

Intervention Type PROCEDURE

Simple suture with or without omental protective patch

Open repair

Patients undergoing open treatment

No interventions assigned to this group

Interventions

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Simple repair or Graham technique

Simple suture with or without omental protective patch

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients surgically treated for benign peptic ulcer perforation

Exclusion Criteria

* Age \< 18 years
* Pregnant and breastfeeding women
* Malignant ulcer perforation
* Gastric resection
* Diagnostic laparoscopy/laparotomy with no further surgical procedures performed
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gianluca Costa

OTHER

Sponsor Role lead

Responsible Party

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Gianluca Costa

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Policlinico San Pietro

Ponte San Pietro, Bergamo, Italy

Site Status RECRUITING

Arcispedale S. Anna di Cona - Azienda Ospedaliero-Universitaria di Ferrara

Ferrara, Emilia-Romagna, Italy

Site Status RECRUITING

Azienda Ospedaliera San Camillo Forlanini di Roma

Rome, Lazio, Italy

Site Status RECRUITING

Ospedale Cristo Re

Rome, Lazio, Italy

Site Status RECRUITING

Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico

Milan, Lombardy, Italy

Site Status RECRUITING

Ospedale Civile di Adria

Adria, Rovigo, Italy

Site Status RECRUITING

Cagliari University Hospital Monserrato

Cagliari, Sardinia, Italy

Site Status RECRUITING

Azienda Ospedaliero Universitaria Ospedale Riuniti Ancona

Ancona, The Marches, Italy

Site Status RECRUITING

Ospedale della Misericordia Grosseto

Grosseto, Tuscany, Italy

Site Status RECRUITING

Azienda Ospedaliera Pisana Policlinico Universitario Cisanello

Pisa, Tuscany, Italy

Site Status RECRUITING

Ospedale San Giovanni Battista

Foligno, Umbria, Italy

Site Status RECRUITING

Azienda Ospedaliera Santa Maria

Terni, Umbria, Italy

Site Status RECRUITING

Fondazione Policlinico Universitario A. Gemelli IRCCS

Rome, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Gianluca Costa, MD, PhD

Role: CONTACT

Phone: 00393921119067

Email: [email protected]

Pietro Fransvea, MD

Role: CONTACT

Phone: 00393289275731

Email: [email protected]

Facility Contacts

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Mauro Montuori, MD

Role: primary

Savino Occhionorelli, MD

Role: primary

Pierluigi Marini, MD

Role: primary

Antonio Crucitti, MD

Role: primary

Giorgio Rossi, MD

Role: primary

Ferdinando Agresta, MD

Role: primary

Adolfo Pisanu, Prof.

Role: primary

Paolo Ruscelli, MD

Role: primary

Paolo Pietro Bianchi, MD

Role: primary

Massimo Chiarugi, MD

Role: primary

Graziano Ceccarelli, MD

Role: primary

Nicola Avenia, MD

Role: primary

Pietro Fransvea

Role: primary

References

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Cirocchi R, Soreide K, Di Saverio S, Rossi E, Arezzo A, Zago M, Abraha I, Vettoretto N, Chiarugi M. Meta-analysis of perioperative outcomes of acute laparoscopic versus open repair of perforated gastroduodenal ulcers. J Trauma Acute Care Surg. 2018 Aug;85(2):417-425. doi: 10.1097/TA.0000000000001925.

Reference Type BACKGROUND
PMID: 29659470 (View on PubMed)

Ge B, Wu M, Chen Q, Chen Q, Lin R, Liu L, Huang Q. A prospective randomized controlled trial of laparoscopic repair versus open repair for perforated peptic ulcers. Surgery. 2016 Feb;159(2):451-8. doi: 10.1016/j.surg.2015.07.021. Epub 2015 Aug 19.

Reference Type RESULT
PMID: 26297055 (View on PubMed)

Siow SL, Mahendran HA, Wong CM, Hardin M, Luk TL. Laparoscopic versus open repair of perforated peptic ulcer: Improving outcomes utilizing a standardized technique. Asian J Surg. 2018 Mar;41(2):136-142. doi: 10.1016/j.asjsur.2016.11.004. Epub 2016 Dec 7.

Reference Type RESULT
PMID: 27955872 (View on PubMed)

Other Identifiers

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I-Go-GIPS_2020_1

Identifier Type: -

Identifier Source: org_study_id