Evaluation of the effectiveness of an endoluminal method for preventing postoperative complications after suturing a perforated duodenal ulcer

Background. Despite the advancement of modern surgical technologies, the rates of postoperative complications and mortality in the treatment of perforated ulcer (PU) show no tendency to decline.

Objective. To evaluate the clinical efficacy of an endoluminal method for the prevention of postoperative complications following suturing or excision of a perforated duodenal ulcer (DU).

Material and methods. Th is study presents the results of surgical treatment of 86 patients with perforated duodenal ulcer. The patients were allocated into two groups: a control group (n = 53) and a main (intervention) group (n = 33). More than 75.0 % of patients in both groups were young and middle-aged men. Open and laparoscopic surgical techniques were employed in both groups; additionally, in the main group, a novel method for the prevention of postoperative complications after DU perforation suturing was applied (RF patent RU2581709C2).

Results. In the control group, a combination of anterior wall ulcer perforation and bleeding from a "mirror" ulcer of the duodenal posterior wall was diagnosed in 8 (15.1 %) patients. The following postoperative complications were observed in the control group: suture line bleeding in 9 (17.0 %) cases, suture failure in 2 (3.8 %) cases, and paralytic ileus in 17 (32.1 %) cases. One patient died postoperatively, resulting in a mortality rate of 1.2 %. In the main (intervention) group, no postoperative complications or fatal outcomes were observed, indicating the high effectiveness of the developed endoluminal method for preventing postoperative complications in the surgical management of perforated duodenal ulcer.

Conclusion. The use of our proprietary multifunctional nasoduodenal tube, which enables a combination of intraluminal compression of the Tachocomb collagen patch to the anterior wall suture line, coverage of the "mirror" ulcer on the posterior duodenal wall, and effective duodenal decompression during the postoperative period, allowed for the prevention of postoperative complications and mortality in patients of the main group.

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