Page 45 - World Journal of Laparoscopic Surgery
P. 45

Use of Laparoscopic vs Open Repair for Perforated Peptic Ulcers


            1 Abnormal Hgb, N (%)              48 (21.9%)         12 (23.1%)        36 (21.6%)
            2 Hypotension, N (%)                     9 (4.11%)      0 (0.00%)         9 (5.39%)
            3 Normal INR, N (%)               156 (90.7%)         33 (94.3%)        123 (89.8%)
            Sepsis, N (%)                       79 (36.1%)        15 (28.8%)        64 (38.3%)         0.281
            Ulcer location, N (%)                                                                      0.029
              Stomach                           94 (42.9%)        15 (28.8%)        79 (47.3%)
              Duodenum                        125 (57.1%)         37 (71.2%)        88 (52.7%)
            Preoperative CT scan, N (%)       193 (88.1%)         46 (88.5%)       147 (88.0%)         1.000
            Image localized                   130 (59.4%)         32 (61.5%)        98 (58.7%)         0.838
            perforation, N (%)
            Time of diagnosis, N (%)                                                                   0.376
              4 Daytime                       121 (55.3%)         32 (61.5%)        89 (53.3%)
              5 Nighttime                       98 (44.7%)        20 (38.5%)        78 (46.7%)
                                                                                                          3
                                                                        3
            SBP, systolic blood pressure; DBP, diastolic blood pressure; WBC, white blood cell (×10 /µL); Hgb, hemoglobin (g/dL); Plt, platelets (×10 /µL); INR,
            international normalized ratio; 1, any deviation from normal range for age and sex; 2, SBP <90 mm Hg; 3, INR >2; 4, between 7 am and 7 pm; 5, 7 pm 7 am
            Table 3: Surgeon demographics
                                                       All           Laparoscopic        Open
                                                    N = 219 (%)       N = 52 (%)      N = 167 (%)      p overall
             Residency graduation after 2006       122 (55.7%)        32 (61.5%)       90 (53.9%)
             Residency hospital type
              Community                              77 (35.2%)       12 (23.1%)       65 (38.9%)
              Tertiary                             142 (64.8%)        40 (76.9%)      102 (61.1%)
             Fellowship                            133 (60.7%)        33 (63.5%)      100 (59.9%)       0.765
             MIS fellowship                          56 (25.6%)       24 (46.2%)       32 (19.2%)      <0.001
            MIS, minimally invasive surgery

            Table 4: Final stepwise regression analysis
                                                     Group = “Laparoscopic”            Group = “Laparoscopic”
            Predictors                       Odds ratios     CI          p     Odds ratios     CI          p
            (Intercept)                        0.14       0.00–6.96    0.328     0.07       0.02–0.31    <0.001
            Age                                0.99       0.97–1.02    0.481
            Sex: Male vs Female                0.79       0.37–1.70    0.545
            BMI                                1.05       1.00–1.11    0.050     1.05       1.01–1.10     0.027
            PPI: Yes vs No                     1.68       0.64–4.39    0.292
            NSAID: Yes vs No                   0.81       0.37–1.77    0.591
            Immunosuppression: Yes vs No       0.79       0.28–2.29    0.670
            Anticoagulation use: Yes vs No     0.77       0.18–3.28    0.726
            Comorbidity: Yes vs No             0.47       0.20–1.13    0.091     0.50       0.24–1.02     0.056
            Previous surgery: Yes vs No        1.53       0.69–3.39    0.300
            Surgeon graduation: 2006 and After vs   1.13  0.51–2.54    0.760
            Before 2006
            Residency type: Tertiary vs Community  2.31   0.98–5.45    0.057     2.23       0.97–5.11     0.058
            Fellowship: Yes vs No              0.32       0.12–0.86    0.024     0.35       0.14–0.87     0.024
            MIS fellow: Yes vs No              5.36        1.99–14.42  0.001     6.42       2.63–15.66   <0.001
            DBP                                1.00       0.97–1.03    0.746
            Preoperative CT scan : Yes vs No   1.61       0.47–5.52    0.448
            Imaging localization: Yes vs No    0.78       0.35–1.71    0.528
            Hemoglobin: Normal vs Abnormal     0.93       0.39–2.21    0.876
            Septic: Yes vs No                  0.68       0.32–1.45    0.314
            Ulcer location: Duodenum vs Stomach  1.45     0.65–3.26    0.368
                                                                                                         (Contd...)


                                                       World Journal of Laparoscopic Surgery, Volume 15 Issue 1 (January–April 2022)  43
   40   41   42   43   44   45   46   47   48   49   50