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All Journal The International Journal of Medical Science and Health Research
Rezky Putri Wahyu Agustine
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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How do laparoscopic versus open surgical repair techniques compare in terms of patient recovery, complication rates, and mortality for perforated peptic ulcers : A Systematic Review Ruditya Lukman Hakim; Rezky Putri Wahyu Agustine
The International Journal of Medical Science and Health Research Vol. 16 No. 5 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/e05z6z96

Abstract

Introduction: Perforated peptic ulcer (PPU) is a life-threatening surgical emergency traditionally managed by open laparotomy. In recent decades, laparoscopic repair has emerged as a prominent minimally invasive alternative. While benefits such as reduced pain and shorter hospital stays are reported, concerns remain regarding longer operative times, specific complications like suture leakage, and inconclusive mortality data. This systematic review aims to comprehensively compare patient recovery, complication rates, and mortality between laparoscopic and open surgical techniques for PPU. Methods: A systematic review was conducted following the PRISMA 2020 guidelines. A comprehensive search of five electronic databases (PubMed, Springer, Semantic Scholar, Google Scholar, Wiley Online Library) was performed to identify comparative studies published in the last decade. The review included randomized controlled trials and observational studies comparing laparoscopic and open repair in adult patients with PPU. After screening and eligibility assessment, 26 studies were included for qualitative synthesis. Results: The synthesis of 26 studies revealed that laparoscopic repair was consistently associated with a significantly shorter postoperative hospital stay (reported in all 16 studies measuring this outcome) and reduced postoperative pain. Furthermore, rates of overall complications and surgical site infections were substantially lower in the laparoscopic group. Conversely, laparoscopy was associated with a longer mean operative time in a majority of studies and a potentially increased risk of suture leakage. The evidence regarding mortality remained inconclusive, as most individual studies were underpowered to demonstrate a statistically significant difference. Conclusion: Laparoscopic repair offers clear and significant advantages over open surgery regarding postoperative recovery, including shorter hospitalization, less pain, and markedly fewer surgical site infections. It should be considered the standard of care for clinically suitable patients. However, the decision must be tempered by the realities of longer operative times and a small but serious risk of suture leakage, which necessitates careful patient selection and adequate surgical expertise. Future large-scale trials are needed to provide definitive conclusions on mortality.
What are the comparative outcomes of laparoscopic versus open surgical techniques in the management of intestinal obstruction in adult patients? : A Systematic Review Ruditya Lukman Hakim; Rezky Putri Wahyu Agustine
The International Journal of Medical Science and Health Research Vol. 16 No. 5 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/bw9pzj51

Abstract

Introduction: Intestinal obstruction is a common surgical emergency traditionally managed by open laparotomy. While laparoscopic surgery has emerged as an alternative with documented short-term benefits, gaps remain, particularly concerning long-term outcomes like recurrence and reoperation rates. This systematic review evaluates the comparative outcomes of laparoscopic versus open surgery for intestinal obstruction in adults to consolidate current evidence and inform clinical practice. Methods: This review followed PRISMA 2020 guidelines. A comprehensive search was conducted across PubMed, Springer, Google Scholar, and other databases for studies published since 2015 comparing laparoscopic and open surgery for intestinal obstruction in adults. Twenty-five studies, including RCTs, cohort studies, and meta-analyses, were selected. Data on operative metrics, recovery outcomes (length of stay, return of bowel function), complications, mortality, and patient-centered outcomes were extracted and synthesized. Results: The synthesis of evidence consistently showed that laparoscopic surgery is associated with significant short-term benefits. These include shorter hospital stays (reported in 17 studies), faster recovery of bowel function (9 studies), lower overall complication rates (20 studies), and reduced intraoperative blood loss (5 studies). Mortality was also generally lower in the laparoscopic group. However, data on operative time was conflicting, and long-term outcomes such as obstruction recurrence and reoperation rates were infrequently and inconsistently reported. Conclusion: Laparoscopic surgery is superior to open surgery for managing intestinal obstruction in adults regarding short-term outcomes, demonstrating clear advantages in recovery, safety, and efficiency. Despite these benefits, a significant evidence gap exists for long-term outcomes. While laparoscopy should be the preferred initial approach, further high-quality, long-term research is needed to solidify its role as the definitive standard of care.
Co-Authors Ruditya Lukman Hakim