Excisional biopsy of perforated gastric ulcer: mandatory or potentially harmful?

Autor: Koca F; Department of General, Visceral, Transplant and Thoracic Surgery, Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany. fkoca@med.uni-frankfurt.de., Koch C; Department of Gastroenterology, Hepatology, Endocrinology and Nutrition, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany., Schulze F; Senckenberg Institute of Pathology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany., Pession U; Department of General, Visceral, Transplant and Thoracic Surgery, Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany., Bechstein WO; Department of General, Visceral, Transplant and Thoracic Surgery, Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany., Malkomes P; Department of General, Visceral, Transplant and Thoracic Surgery, Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2024 Jul 04; Vol. 409 (1), pp. 205. Date of Electronic Publication: 2024 Jul 04.
DOI: 10.1007/s00423-024-03393-x
Abstrakt: Purpose: This study aimed to evaluate the morbidity associated with excisional biopsy in patients with spontaneous gastric perforation.
Methods: A retrospective, single-center, observational study was performed. All consecutive patients with spontaneous gastric perforation who underwent surgical therapy were included. Outcomes were assessed concerning the performance of excisional biopsy.
Results: A total of 135 adult patients were enrolled. Of these, 110 (81.5%) patients underwent excisional biopsy, while 17 (12.6%) did not. The remaining eight (5.9%) patients who underwent gastric resection were excluded from the analysis. Patients undergoing excisional biopsy developed significantly higher rates of postoperative complications (p = 0.007) and experienced more severe complications according to the Clavien-Dindo classification, particularly type III and above (p = 0.017). However, no significant differences were observed regarding in-hospital mortality, reoperation, suture dehiscence, or length of hospital stay.
Conclusion: Excisional biopsy for gastric perforation has been shown to be associated with increased morbidity. Surgical closure followed by early endoscopic biopsy may be a superior approach for gastric perforation management to rule out malignancy.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: