{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T03:12:33Z","timestamp":1648782753535},"reference-count":0,"publisher":"Akademiai Kiado Zrt.","issue":"4","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["MaSeb"],"published-print":{"date-parts":[[2020,12,12]]},"abstract":"\u00d6sszefoglal\u00f3.<\/jats:bold>\n Bevezet\u00e9s:<\/jats:italic> A protonpumpag\u00e1tl\u00f3 kezel\u00e9s \u00e9s Helicobacter pylori\n eradik\u00e1ci\u00f3 k\u00f6vetkezt\u00e9ben a fek\u00e9lyincidencia cs\u00f6kkent, a fek\u00e9lyb\u0151l sz\u00e1rmaz\u00f3\n v\u00e9rz\u00e9sek sz\u00e1ma is cs\u00f6kkent, ellenben a perfor\u00e1ci\u00f3k el\u0151fordul\u00e1sa v\u00e1ltozatlanul\n 2\u201310% k\u00f6z\u00f6tt van. A perfor\u00e1ci\u00f3 egy potenci\u00e1lisan fat\u00e1lis seb\u00e9szi s\u00fcrg\u0151ss\u00e9gi\n helyzet, a mortalit\u00e1s el\u00e9rheti a 25%-ot, a morbidit\u00e1s pedig az 50%-ot. Az id\u0151ben\n v\u00e9gzett s\u00fcrg\u0151s seb\u00e9szi kezel\u00e9s jav\u00edthatja az eredm\u00e9nyeket.\n C\u00e9lkit\u0171z\u00e9s:<\/jats:italic> A fek\u00e9lyperfor\u00e1ci\u00f3 nyitott \u00e9s laparoszk\u00f3pos\n m\u00f3don t\u00f6rt\u00e9nt ell\u00e1t\u00e1s\u00e1nak \u00f6sszehasonl\u00edt\u00e1sa a morbidit\u00e1s, mortalit\u00e1s, m\u0171t\u00e9ti id\u0151\n \u00e9s \u00e1pol\u00e1si id\u0151 alapj\u00e1n. Eredm\u00e9nyek:<\/jats:italic> 2017. 01. 01. \u00e9s 2019. 06.\n 30. k\u00f6z\u00f6tt 55 m\u0171t\u00e9t t\u00f6rt\u00e9nt gastro-duoden\u00e1lis fek\u00e9lyperfor\u00e1ci\u00f3 miatt, 31 m\u0171t\u00e9tet\n (56,36%) nyitott \u00e9s 24 m\u0171t\u00e9tet (43,63%) pedig laparoszk\u00f3pos m\u00f3don v\u00e9gezt\u00fcnk. A\n laparoszk\u00f3pos csoportban 4 konverzi\u00f3 t\u00f6rt\u00e9nt (16,6%). A nyitott m\u0171t\u00e9ti\n csoportban 23 f\u00e9rfi (\u00e1tlag\u00e9letkor 56,3 \u00e9v) \u00e9s 8 n\u0151 volt (\u00e1tlag\u00e9letkor 70,3 \u00e9v),\n m\u00edg a laparoszk\u00f3pos csoportban 13 f\u00e9rfi (\u00e1tlag\u00e9letkor 49,7 \u00e9v) \u00e9s 11 n\u0151\n (\u00e1tlag\u00e9letkor 53,7 \u00e9v) volt. A nyitott csoportban 5, a laparoszk\u00f3pos csoportban\n 2 sz\u00f6v\u0151dm\u00e9ny fordult el\u0151 (p<\/jats:italic> = 0,45). Az \u00e1tlagos m\u0171t\u00e9ti id\u0151 a\n nyitott m\u0171t\u00e9tn\u00e9l 51,95 perc (30\u201385), m\u00edg a laparoszk\u00f3pos m\u0171t\u00e9tn\u00e9l 63,41 (25\u2013110)\n perc volt (p<\/jats:italic> = 0,13). A nyitott csoportb\u00f3l 6 (\u00e1tlag\u00e9letkor 74,3\n \u00e9v), a laparoszk\u00f3pos csoportb\u00f3l pedig 2 (\u00e1tlag\u00e9letkor 68,5 \u00e9v) beteget\n vesz\u00edtett\u00fcnk el 30 napon bel\u00fcl (p<\/jats:italic> = 0,44). Az \u00e1tlagos \u00e1pol\u00e1si\n id\u0151 a nyitott csoportban 7,13 (5\u201316), a laparoszk\u00f3pos csoportban pedig 6,19\n (4\u201313) napnak bizonyult (p<\/jats:italic> = 0,24). Az \u00e1tlagos perfor\u00e1ci\u00f3m\u00e9ret\n a nyitott m\u0171t\u00e9ti csoportban 7,4 mm (3\u201320 mm), m\u00edg a laparoszk\u00f3pos m\u0171t\u00e9ti\n csoportban 5,3 mm (3\u201310 mm) volt (p<\/jats:italic> = 0,14). Szabad leveg\u0151\n nat\u00edv hasi r\u00f6ntgenvizsg\u00e1laton a nyitott csoportban 25 esetben (80%), m\u00edg a\n laparoszk\u00f3pos csoportban 13 esetben volt l\u00e1that\u00f3 (54%).\n Megbesz\u00e9l\u00e9s:<\/jats:italic> A korai diagn\u00f3zis, az azonnal kezdett\n szupport\u00edv \u00e9s antibiotikus kezel\u00e9s \u00e9s a s\u00fcrg\u0151s m\u0171t\u00e9t elengedhetetlen az\n eredm\u00e9nyek jav\u00edt\u00e1s\u00e1hoz. A standard m\u0171t\u00e9t a sutura csepleszlebennyel, amit lehet\n nyitottan \u00e9s laparoszk\u00f3ppal is v\u00e9gezni. B\u00e1r a viszonylag kis esetsz\u00e1m miatt\n anyagunkban nem siker\u00fclt igazolni a sz\u00f6v\u0151dm\u00e9nyek ar\u00e1ny\u00e1nak szignifik\u00e1ns\n cs\u00f6kken\u00e9s\u00e9t, az irodalmi adatok alapj\u00e1n a laparoszk\u00f3pos beavatkoz\u00e1snak kisebb a\n morbidit\u00e1sa, mint a ny\u00edlt m\u0171t\u00e9tnek, \u00e9s ha nincs ellenjavallata a\n laparoszk\u00f3pi\u00e1nak (anamn\u00e9zisben t\u00f6bbsz\u00f6r\u00f6s hasi m\u0171t\u00e9t, nem kell\u0151 laparoszk\u00f3pos\n gyakorlat, felv\u00e9telkori sokkos \u00e1llapot \u00e9s magas \u00e9letkor), a laparoszk\u00f3pia\n \u00e1ltal\u00e1nos el\u0151nyei miatt \u00e9s a szabadleveg\u0151-hi\u00e1ny okozta diagnosztikus\n bizonytalans\u00e1g eset\u00e9n is a laparoszk\u00f3pia els\u0151 v\u00e1laszt\u00e1sk\u00e9nt javasolhat\u00f3.<\/jats:p>\n Summary.<\/jats:bold>\n Introduction:<\/jats:italic> The incidence of peptic ulcer disease decreased\n due to proton pump inhibitors and Helicobacter pylori eradication. Bleeding from\n peptic ulcer decreased, as well, although perforation did not decrease and it is\n permanently between 2\u201310%. This is a potential surgical emergency, the mortality\n can reach up to 25% and the morbidity 50%, respectively. Urgent surgical\n intervention in the right time can improve the results. Aim:<\/jats:italic> To\n compare the morbidity, mortality, the length of hospital stay and duration of\n operating time in open and laparoscopic repair of perforated peptic ulcer.\n Results:<\/jats:italic> A cohort of 55 patients were operated on with\n perforated peptic ulcer from 01.01.2017 to 30.06.2019 31 open (51.36%) and 24\n laparoscopic (43.63%) operations were performed from which 4 (16.6%) needed\n conversion to open approach. The average age of 23 men and 8 women were 56.3 and\n 70.3 years respectively in the open operations group, while 13 men and 11 women\n with average age of 49.7 and 53.7 years was in the laparoscopic operations\n group. Within 30 days the number of complications were 5 in the open and 2 in\n the laparoscopic group (p<\/jats:italic> = 0.45). The average duration of\n operation was 51.95 minutes (30\u201385) in the open and 63.41 minutes (25\u2013110) in\n the laparoscopic group (p<\/jats:italic> = 0.13). 6 from the open group with\n average age of 74.3 years and 2 from the laparoscopic group with average age of\n 68.5 years died within 30 days (p<\/jats:italic> = 0.44). The average length\n of stay was 7.13 (5\u201316) days in the open and 6.19 (4\u201313) days in the\n laparoscopic group (p<\/jats:italic> = 0.24). The average size of the\n perforation was 7.4 mm (3\u201320) in the open and 5.3 mm (3\u201310) in the laparoscopic\n group (p<\/jats:italic> = 0.14). Free air was seen in the abdominal cavity in\n 25 cases (80%) of the open and in 11 cases (54%) of the laparoscopic group.\n Conclusion:<\/jats:italic> Early diagnosis, prompt supportive care and\n antibiotic treatment and urgent surgical intervention are essential to improve\n outcomes. The standard operation is the simple suture with pedicled omental flap\n which can be performed by either open or laparoscopic surgical repair.\n Laparoscopic method spreads slowly, the learning curve is longer and it needs\n more expertise but the morbidity is lower than that of the open surgery. The\n morbidity does not increase after conversion according to the literature so if\n there is no contraindication and there is enough expertise it should be\n suggested as the first choice.<\/jats:p>","DOI":"10.1556\/1046.73.2020.4.2","type":"journal-article","created":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T03:11:47Z","timestamp":1608952307000},"page":"140-147","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":0,"title":["Laparoszk\u00f3pia helye a gastro-duoden\u00e1lis fek\u00e9lyperfor\u00e1ci\u00f3k ell\u00e1t\u00e1s\u00e1ban"],"prefix":"10.1556","volume":"73","author":[{"given":"Korn\u00e9l","family":"Vajda","sequence":"first","affiliation":[{"name":"1 B\u00e1cs-Kiskun Megyei K\u00f3rh\u00e1z, Seb\u00e9szeti Oszt\u00e1ly, 6000 Kecskem\u00e9t, Ny\u00edri u 38."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Sikorszki","sequence":"additional","affiliation":[{"name":"1 B\u00e1cs-Kiskun Megyei K\u00f3rh\u00e1z, Seb\u00e9szeti Oszt\u00e1ly, 6000 Kecskem\u00e9t, Ny\u00edri u 38."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","container-title":["Magyar Seb\u00e9szet (Hungarian Journal of Surgery)"],"original-title":[],"link":[{"URL":"https:\/\/akjournals.com\/view\/journals\/1046\/73\/4\/article-p140.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/1046\/73\/4\/article-p140.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T05:03:55Z","timestamp":1628312635000},"score":1,"resource":{"primary":{"URL":"https:\/\/akjournals.com\/view\/journals\/1046\/73\/4\/article-p140.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,12]]},"references-count":0,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.1556\/1046.73.2020.4.2","relation":{},"ISSN":["0025-0295","1789-4301"],"issn-type":[{"value":"0025-0295","type":"print"},{"value":"1789-4301","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,12]]}}}