Ümran MUSLU, Hüdai GENÇ, Özcan ALTINEL, Gündüz AKGÖL, Ayşegül DEMİR, Eyüp Sabri TEZCAN, Orhan ÜREYEN, Mustafa ATABEY, Ali Kağan GÖKAKIN

Mortality and morbidity risk factors in the surgery of peptic ulcer perforation

Amaç. Modern tedavi ile medikal peptik ülser perforasyonu insidansının azalmasına ve ülserperforasyonu epidemiyolojisinin değişmesine karşın, perforasyonlara bağlı ölüm oranlarındabenzer azalma sağlanamamıştır. Bu çalışmada peptik ülser perforasyonunda gözlenen morbidite vemortalite ile ilişkili faktörler ve daha basit cerrahi işlemlerin rolü irdelenmiştir. Yöntem. Ocak1998-Aralık 2005 yılları arasında peptik ülser perforasyonu nedeniyle opere edilen 126 hasta, arşivkayıtlarından retrospektif olarak incelendi. Hastalar, primer tamir ve kesin cerrahi uygulananlarolarak ikiye ayrıldı. Uygulanacak cerrahi tipini etkileyen faktörler, perforasyon etyolojisi,mortalite ve morbiditeyi etkileyen faktörler değerlendirildi. Bulgular. Hastaların 114 (%90,5) üerkek, 12 (%9,5) si kadın olup yaş ortalaması 50,7 (±13,5) idi. Hastaların 103 (%81,7)üne primersütür, 23 (%18,3)üne kesin ülser cerrahisi uygulandı. Genel mortalite oranı %3,9, genel morbiditeoranı ise %15 idi. Hastaların mortalite ve morbidite ile ilişkili risk faktörlerinin yaş (>60), yandaşhastalığın varlığı ve hastaneye geç başvuru olduğu saptandı Sonuç. Peptik ülser perforasyonucerrahisinde primer tamir zamanla yeniden popular olmuştur. Hastaneye geç başvuru, yaş, eşlikeden hastalık ve operasyon tipi morbidite ve mortalite ile ilişkili faktörler olarak bulundu.

Pep tik ülser p erf orasyonlarında mortalite ve morbidite için risk faktörleri

Aim. The efficacy of modern medical treatment has played an important role in decreasedincidence and differentation of the epidemiology of ulcer perforation. But a similar rate ofdifferentiation in mortality and morbidity was not observed. The effect of more simple surgicalprocedures and the factors associated with mortality and morbidity in ulcer perforation, were thesubject of this study. Methods. The files of 126 patients who were operated due to peptic ulcerperforation between 1998 and 2005 were analyzed in retrospective manner. Patients were dividedinto two groups as primary repair group and definitive surgery group. Factors affecting the choiceof surgical treatment, perforation etiology, predisposing factors associated with mortality andmorbidity rate were evaluated. Results. A hundred and fourteen 114 (90.5%) patients were maleand 12 (9.5%) of them were female. The mean age was 50.7 (± 13.5). Primary repair groupincluded 103 (81.7%) patients whereas definitive surgery group included 23 (18.3%) patients. Theoverall mortality and morbidity rates in primary repair group and definitive surgery were, 3.9%and 15% respectively. Conclusion. Primary repair has re-gained popularity in time. The factorsassociated with mortality and morbidity were age, concomitant disease, and delayed admission.

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