RESUMEN

INTRODUCTION: This study aimed to clarify the validity of laparoscopic surgery for lower gastrointestinal perforation by comparing the clinical outcomes of laparoscopic and open emergency surgery. METHODS: We reviewed the data of patients who underwent surgery for lower gastrointestinal perforation. Patients were categorized into two groups: the laparoscopic group who underwent laparoscopic surgery, and the open group who underwent laparotomy. Clinical and operative outcomes between the two groups were evaluated. RESULTS: A total of 219 patients were included in the study. There were 66 and 153 patients with small bowel and colorectal perforations, respectively. The median operative time in the laparoscopic group was shorter than that in the open group (126 min vs. 146 min, p = .049). The mean amount of intraoperative blood loss was significantly lower in the laparoscopic group (50.4 mL vs. 400.1 mL, p < .001). The incidence of postoperative complication was higher in the open group (20.0% vs. 66.5%, p < .001), especially wound infection (0% vs. 26.3%, p = .002). Median hospital stays were 14 days and 24 days in the laparoscopic and open groups, respectively (p < .001). In the laparoscopic group, hospital mortality was 0%. CONCLUSIONS: The laparoscopic approach for small bowel and colorectal perforation in an emergency setting is a safe procedure in carefully selected patients and may contribute to decreased intraoperative blood loss, shortened hospital stay, and decreased incidence of postoperative complications, especially wound infection.

Asunto(s)

Perforación Intestinal , Laparoscopía , Humanos , Laparoscopía/efectos adversos , Perforación Intestinal/cirugía , Perforación Intestinal/etiología , Femenino , Masculino , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Adulto , Resultado del Tratamiento , Complicaciones Posoperatorias/epidemiología , Tempo Operativo , Tiempo de Internación/estadística & datos numéricos , Anciano de 80 o más Años , Intestino Delgado/cirugía , Intestino Delgado/lesiones , Laparotomía

RESUMEN

The heating effect on the adhesion property of plasma-treated polytetrafluoroethylene (PTFE) was examined. For this purpose, a PTFE sheet was plasma-treated at atmospheric pressure while heating using a halogen heater. When plasma-treated at 8.3 W/cm2 without using the heater (Low-P), the surface temperature of Low-P was about 95 °C. In contrast, when plasma-treated at 8.3 W/cm2 while using the heater (Low-P+Heater), the surface temperature of Low-P+Heater was controlled to about 260 °C. Thermal compression of the plasma-treated PTFE with or without heating and isobutylene-isoprene rubber (IIR) was performed, and the adhesion strength of the IIR/PTFE assembly was measured via the T-peel test. The adhesion strengths of Low-P and Low-P+Heater were 0.12 and 2.3 N/mm, respectively. Cohesion failure of IIR occurred during the T-peel test because of its extremely high adhesion property. The surfaces of the plasma-treated PTFE with or without heating were investigated by the measurements of electron spin resonance, X-ray photoelectron spectroscopy, nanoindentation, scanning electron microscopy, and scanning probe microscopy. These results indicated that heating during plasma treatment promotes the etching of the weak boundary layer (WBL) of PTFE, resulting in a sharp increase in the adhesion property of PTFE.