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Simple closure provides a time-saving surgical approach without compromising outcomes in patients undergoing repair of perforated peptic ulcers.
Perforated peptic ulcer continues to pose a significant surgical challenge, often requiring urgent intervention to prevent serious complications and death. While both simple closure and omental patch repair are established treatment strategies, evidence comparing their relative benefits remains inconsistent. Researchers therefore evaluated available comparative data to determine whether either approach offers advantages in postoperative outcomes and recovery.
A systematic search of Europe PMC, Medline, Scopus, and the Cochrane Library was conducted to identify studies directly comparing simple closure with omental patch repair in patients undergoing surgery for perforated peptic ulcer. Eligible studies were selected according to predefined criteria, and pooled analyses were carried out via Review Manager 5.4. Outcomes of interest included:
Effect estimates were calculated using random-effects models to account for interstudy variability. Analysis of 8 comparative studies demonstrated broadly similar postoperative outcomes between simple closure and omental patch repair, with operative time emerging as the primary differentiating factor (Table 1).
Additionally, no significant differences were identified in length of hospital stay (mean difference [MD] −0.21 days) or time to oral intake (MD −0.08 days). In contrast, operative duration was significantly lower with simple closure, with procedures completed an average of 21.73 minutes faster. Overall, the study demonstrated no meaningful differences between simple closure and omental patch repair regarding postoperative complications, recovery outcomes, or mortality. However, the ability of simple closure to substantially reduce operative time underscored its value as an efficient surgical option without compromising patient outcomes.
Foregut: The Journal of the American Foregut Society
Simple Closure Versus Omental Patch in the Surgical Management of Perforated Peptic Ulcer: A Meta-Analysis of Comparative Studies
Andrea Hasudungan et al.
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