A comparative study of conventional vs. laparoscopic operations in the surgical management of peritonitis

Abstract

Purpose and objectives. The purpose of this paper was to compare the “outcomes” of patients with peritonitis according to the surgical method selected (laparoscopic vs. conventional/open), in the treatment of such a severe pathology, in order to obtain an efficient management of postoperative morbidities and the reduction of the mortality rate (currently estimated at 5% - 40%). Material and method. We carried out a retrospective, observational, non-randomized study on a sample of hospitalized patients, based on a descriptive and analytical epidemiological investigation, supported by the laparoscopic experience of the General Surgery Clinic in “Sf. Ioan” Emergency Clinical Hospital of Bucharest in the last decade (01.01.2009-31.12.2018). Results. We identified a sample of 378 patients with peritonitis, of which 109 were operated laparoscopically (i.e. 28.84%), and 269 patients (i.e. 71.16%) were operated traditionally. Following a rough analysis, it was observed that patients who underwent open surgery were hospitalized on an average 4.73 days longer than those operated laparoscopically (11.67 days vs. 6.94 days), the effect being statistically significant (p < 0.01). In the traditionally operated group of patients, the average duration of surgery was 46.31 minutes longer than those operated laparoscopically (113.92 vs. 67.60), the effect being also statistically significant (p < 0.01). Conclusions. The conventional surgical approach is statistically significantly associated with an increased duration of operative time and hospitalization in patients with peritonitis and can be considered a factor of severe evolutive prognosis in the therapeutic management of this pathology.

Keywords

• peritonitis
• laparotomy
• prognostic factors
• sepsis