title: Meta-analysis of laparoscopic versus open repair of perforated peptic ulcer.
abstract: OBJECTIVE
  Laparoscopic treatment of perforated peptic ulcer (PPU) has been introduced as an alternative procedure to open surgery. It has been postulated that the minimally invasive approach involves less operative stress and results in decreased morbidity and mortality.
  
  
  METHODS
  We conducted a meta-analysis of randomized trials to test this hypothesis. Medline, EMBASE, and the Cochrane Central Register of Randomized Trials databases were searched, with no date or language restrictions.
  
  
  RESULTS
  Our literature search identified 4 randomized trials, with a cumulative number of 289 patients, that compared the laparoscopic approach with open sutured repair of perforated ulcer. Analysis of outcomes did not favor either approach in terms of morbidity, mortality, and reoperation rate, although odds ratios seemed to consistently support the laparoscopic approach. Results did not determine the comparative efficiency and safety of laparoscopic or open approach for PPU.
  
  
  CONCLUSIONS
  In view of an increased interest in the laparoscopic approach, further randomized trials are considered essential to determine the relative effectiveness of laparoscopic and open repair of PPU.
authors.affiliation: Center for Minimally Invasive Surgery, Hospital Neuwerk, Mönchengladbach, Germany. stavros.antoniou@hotmail.com
authors.forename: Stavros A
authors.initials: SA
authors.lastname: Antoniou
authors.forename: George A
authors.initials: GA
authors.lastname: Antoniou
authors.forename: Oliver O
authors.initials: OO
authors.lastname: Koch
authors.forename: Rudolph
authors.initials: R
authors.lastname: Pointner
authors.forename: Frank A
authors.initials: FA
authors.lastname: Granderath
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D016017:Odds Ratio; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome