Peptik Ülser Perforasyonu: Laparoskopik ve Açık Onarımın Klinik sonuçları

Abstract

Amaç: Bu çalışma, peptik ülser perforasyonu (PUP) olgularında laparoskopik ve açık cerrahi onarım yöntemlerinin perioperatif ve postoperatif sonuçlarını karşılaştırarak minimal invaziv cerrahinin etkinliğini ve güvenilirliğini değerlendirmeyi amaçlamaktadır. Yöntemler: Temmuz 2020–2025 tarihlerinde PUP nedeniyle opere edilen 80 hasta retrospektif olarak değerlendirildi. Laparoskopik cerrahi uygulanan Grup A (n = 35) ile açık cerrahi uygulanan Grup B (n = 45), klinik ve cerrahi sonuçlar açısından karşılaştırıldı. Analizlerde p<0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Grupların demografik ve preoperatif özellikleri benzerdi. Laparoskopik grupta ameliyat süresi (80,5 ± 15,2 dk), dren çekilme (3,3 ± 0,9 gün), oral alıma geçiş (1,9 ± 0,8 gün) ve hastanede kalış süreleri (5,4 ± 1,2 gün) açık cerrahi grubuna göre sırasıyla 106,9 ± 21,3 dk, 5,1 ± 1,1 gün, 5,1 ± 1,4 gün ve 10,0 ± 2,5 gün olup anlamlı derecede daha kısaydı (p < 0,001). Postoperatif 1. gün ağrı skoru laparoskopik grupta 4,1 ± 0,8, açık grupta 6,0 ± 1,1 bulundu (p < 0,001). Komplikasyon oranları cerrahi alan enfeksiyonu (CAE) (p = 0,024), atelektazi (p = 0,002) ve insizyonel herni (p = 0,032)] açık cerrahi grubunda anlamlı olarak daha yüksek bulundu Sonuç: Laparoskopik onarım, PUP tedavisinde açık cerrahiye kıyasla daha kısa ameliyat süresi, azalmış komplikasyon oranı ve belirgin ağrı kontrolüyle iyileşmeyi hızlandırmaktadır. Laparoskopik yaklaşım, güvenli ve etkili bir yöntem olup, hasta konforunu ve postoperatif iyileşmeyi sürecine olumlu katkı sağlayabilir.

Keywords

• Peptik ülser perforasyonu
• laparoskopik cerrahi
• açık onarım
• postoperatif komplikasyon

Peptic Ulcer Perforation: Clinical Outcomes of Laparoscopic and Open Repair

Abstract

Objective: This study aimed to assess the efficacy and safety of minimally invasive surgery by comparing perioperative and postoperative outcomes between laparoscopic and open repair in patients with peptic ulcer perforation (PUP). Methods: Eighty patients who underwent surgery for PUP between July 2020 and 2025 were retrospectively analyzed. Patients were divided into two groups: Group A (n = 35) underwent laparoscopic repair, and Group B (n = 45) underwent open repair. Clinical and surgical outcomes were compared. A p value of <0,05 was considered statistically significant. Results: Baseline demographic and preoperative characteristics were comparable between the groups. In the laparoscopic group, the operation time (80,5 ± 15,2 min), drain removal (3,3 ± 0,9 days), time to oral intake (1,9 ± 0,8 days), and hospital stay (5,4 ± 1,2 days) were significantly shorter than those in the open group (106,9 ± 21,3 min, 5,1 ± 1,1 days, 5,1 ± 1,4 days, and 10,0 ± 2,5 days, respectively; p < 0,001). The pain score on the first postoperative day was significantly lower in the laparoscopic group (4,1 ± 0,8) compared with the open group (6,0 ± 1,1; p < 0,001). Complication rates—including surgical site infection (p = 0,024), atelectasis (p = 0,002), and incisional hernia (p = 0,032)—were markedly higher in the open surgery group. Conclusion: Laparoscopic repair significantly enhances recovery in PUP management through shorter operative times, reduced complication rates, and superior postoperative pain control compared with open surgery. It represents a safe and effective approach that improves patient comfort and accelerates postoperative recovery.

Keywords

• Peptic ulcer perforation
• laparoscopic surgery
• open repair
• postoperative complications.

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