Pathophysiology and surgical outcomes of patients with fungal peritonitis from upper gastrointestinal tract perforation: a retrospective study.

Autor: Nyumura Y; Department of Surgery, Fuji City General Hospital, 50, Takashima-Cho, Fuji-Shi, Shizuoka, 417-8567, Japan. nyumura@jikei.ac.jp.; Department of Gastrointestinal Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan. nyumura@jikei.ac.jp., Tsuboi K; Department of Surgery, Fuji City General Hospital, 50, Takashima-Cho, Fuji-Shi, Shizuoka, 417-8567, Japan., Suzuki T; Department of Surgery, Fuji City General Hospital, 50, Takashima-Cho, Fuji-Shi, Shizuoka, 417-8567, Japan., Kajimoto T; Department of Surgery, Fuji City General Hospital, 50, Takashima-Cho, Fuji-Shi, Shizuoka, 417-8567, Japan., Tanishima Y; Department of Gastrointestinal Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan., Yano F; Department of Gastrointestinal Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan., Eto K; Department of Gastrointestinal Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.
Jazyk: angličtina
Zdroj: Surgery today [Surg Today] 2024 Nov; Vol. 54 (11), pp. 1345-1352. Date of Electronic Publication: 2024 Apr 30.
DOI: 10.1007/s00595-024-02851-9
Abstrakt: Purpose: To compare the pathophysiology and surgical outcomes of emergency surgery for upper gastrointestinal tract perforation with and without fungal peritonitis and identify the risk factors for fungal peritonitis.
Methods: The subjects of this retrospective study were patients with upper gastrointestinal perforation and peritonitis who underwent emergency surgery at a single medical center in Japan. The patients were allocated to two groups according to the presence or absence of fungal peritonitis: group F and group N, respectively.
Results: At the time of surgery, ascitic fluid culture or serum β-D glucan levels were available for 54 patients: 29 from group F and 25 from group N, respectively. The stomach was perforated in 14 patients (25.9%) and the duodenum was perforated in 40 patients (74.1%). Group F had a higher proportion of patients with low preoperative prognostic nutritional index scores (≤ 40) and C-reactive protein levels and a higher postoperative complication rate. The time to initiate food intake and the postoperative hospital stay were also significantly longer in group F. Multivariate analysis identified that the perforation site of the stomach was a risk factor for fungal peritonitis.
Conclusion: Patients with fungal peritonitis from upper gastrointestinal tract perforation had higher postoperative complication rates, delayed postoperative recovery, and a longer hospital stay. Gastric perforation was a risk factor for fungal peritonitis.
(© 2024. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.)
Databáze: MEDLINE
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