SurgeryLOREPUPNCT04447170
Laparoscopic Versus Open Repair of Peptic Ulcer Perforation
An observational study of Surgery and Emergencies, run by Gianluca Costa at 13 sites in Italy.
Trial summary
Although laparoscopic repair (LR) of perforated peptic ulcers (PPUs) has long been accepted, clinical evidence comparing LR versus open repair (OR) remains lacking. The aim of this study is to evaluate the feasibility, safety and outcome of laparoscopic gastric repair and compare it with the outcome open repair by… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Surgery, Emergencies, Peptic Ulcer Perforation
- What is being tested?
- Simple repair or Graham technique
- Type of treatment
- Surgery or procedure
- How many people
- 200 participants
- Where
- 13 sitesItaly
- Study dates
- 1 Jan 2017to 1 Apr 2022
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Multicenter italian national case-control study
Who may be able to join
- Patients surgically treated for benign peptic ulcer perforation
Who cannot join
- Age < 18 years
- Pregnant and breastfeeding women
- Malignant ulcer perforation
- Gastric resection
- Diagnostic laparoscopy/laparotomy with no further surgical procedures performed
Trial locations and contacts
13 sites in 1 country.
13 sites in 1 country
Italy13 sites, 13 recruiting
- Recruiting
Ospedale Civile di Adria
Adria, Rovigo
Ferdinando Agresta, MD
Elena Finotti, MD
- Recruiting
Azienda Ospedaliero Universitaria Ospedale Riuniti Ancona
Ancona, The Marches, 60121
Paolo Ruscelli, MD
Pietro Coletta, MD
- Recruiting
Cagliari University Hospital Monserrato
Cagliari, Sardinia
Adolfo Pisanu, Prof.
Mauro Podda, MD
- Recruiting
Arcispedale S. Anna di Cona - Azienda Ospedaliero-Universitaria di Ferrara
Ferrara, Emilia-Romagna
Savino Occhionorelli, MD
Savino Occhionorelli, MD
- Recruiting
Ospedale San Giovanni Battista
Foligno, Umbria, 06034
Graziano Ceccarelli, MD
- Recruiting
Ospedale della Misericordia Grosseto
Grosseto, Tuscany, 58100
Paolo Pietro Bianchi, MD
Martina De Luca, MD
- Recruiting
Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
Milan, Lombardy, 20122
Giorgio Rossi, MD
Tiberio Canini, MD
- Recruiting
Azienda Ospedaliera Pisana Policlinico Universitario Cisanello
Pisa, Tuscany, 56121
Massimo Chiarugi, MD
Dario Tartaglia, MD
- Recruiting
Policlinico San Pietro
Ponte San Pietro, Bergamo
Mauro Montuori, MD
Enrico Pinotti, MD
- Recruiting
Azienda Ospedaliera San Camillo Forlanini di Roma
Rome, Lazio
Pierluigi Marini, MD
Pietro Fransvea, MD
- Recruiting
Ospedale Cristo Re
Rome, Lazio
Antonio Crucitti, MD
Casimiro Nigro, MD
- Recruiting
Fondazione Policlinico Universitario A. Gemelli IRCCS
Rome
Pietro Fransvea
Pietro Fransvea
- Recruiting
Azienda Ospedaliera Santa Maria
Terni, Umbria
Nicola Avenia, MD
Fabio Rondelli, MD
About this study
Official title: Comparison Between Laparoscopic and Open Repair of Perforated Gastroduodenal Peptic Ulcer
Although laparoscopic repair (LR) of perforated peptic ulcers (PPUs) has long been accepted, clinical evidence comparing LR versus open repair (OR) remains lacking. The aim of this study is to evaluate the feasibility, safety and outcome of laparoscopic gastric repair and compare it with the outcome open repair by relying on a propensity score matching statistical technique
Read the detailed description
Despite the evolution of medical management of Gastroduodenal Peptic Ulcer (GPU), complications like bleeding and perforation are still not uncommon in clinical practice. According to the literature in average, 2-14% of peptic ulcers result in perforation, most 215 commonly occurring in females over the age of 60 and chronic NSAID, alcohol or tobacco users.
Management of perforated peptic ulcer entails resuscitation, pharmacotherapy and surgery.
Traditionally, suture with or without omental patch has been considered the 'gold standard' and still is. It is associated with shorter length of stay, lower transfusion needs and has lower morbidity as compared to gastrectomy. In 1992, it has been proposed that laparoscopy should be routinely considered in the management of perforated duodenal ulcer. Nowadays due to the advances in laparoscopic technique, many publications suggest that laparoscopic repair of perforated peptic ulcers could be a superior choice to open repair. These is linked with the advantages of laparoscopic surgery over open surgery such as reduced postoperative pain, lower wound infection rate, decreased length of hospital stay, and earlier functional recovery
- Conditions
- Surgery, Emergencies, Peptic Ulcer Perforation
- Being tested
- Simple repair or Graham technique
- Keywords
- Peptic ulcer perforation, Laparoscopy
- Medical subject headings
- Emergencies, Peptic Ulcer Perforation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Simple repair or Graham techniqueProcedure or surgery
Simple suture with or without omental protective patch
| Study group | Role | What they receive |
|---|---|---|
| Laparoscopic repair | Patients undergoing laparoscopic treatment Receives: Procedure: Simple repair or Graham technique | |
| Open repair | Patients undergoing open treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
30-day Mortality Rate
Measured: 18 months
30-day Morbidity Rate
Morbidity defined by mean of the most used classification scoring system
Measured: 18 months
Secondary outcomes (7)
Conversion rate
Defined when a procedure was attempted via the minimally invasive approach but required an open incision to be completed
Measured: 18 months
Calculation of Boey index
Calculation and evaluation of its predictive value for morbidity and mortality
Measured: 18 months
Calculation of Mannheim Peritonitis Index
Calculation and evaluation of its predictive value for morbidity and mortality
Measured: 18 months
Calculation of Shock index
Calculation and evaluation of its predictive value for morbidity and mortality
Measured: 18 months
Calculation of Age-related shock index
Calculation and evaluation of its predictive value for morbidity and mortality
Measured: 18 months
Operative time
The duration time of surgical step from in
The duration of the surgical procedure
Measured: 18 months
Calculation of Charlson Age-Comorbidity Index (CACI)
Calculation and evaluation of its predictive value for morbidity and mortality
Measured: 18 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Jun 2020
- Study start1 Jan 2017
- Primary completion30 Nov 2021
- Study completion1 Apr 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for SurgeryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Other
- Enrolment
- 200 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Gianluca Costa
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Gianluca Costa, University of Roma La Sapienza
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04447170
- Sponsor's protocol ID
- I-Go-GIPS_2020_1
- Acronym
- LOREPUP
- Status last verified
- Dec 2021
- First submitted
- 19 Jun 2020
- Last updated
- 29 Dec 2021
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Cirocchi R, Soreide K, Di Saverio S, Rossi E, Arezzo A, Zago M, Abraha I, Vettoretto N, Chiarugi M. Meta-analysis of perioperative outcomes of acute laparoscopic versus open repair of perforated gastroduodenal ulcers. J Trauma Acute Care Surg. 2018 Aug;85(2):417-425. doi: 10.1097/TA.0000000000001925.
PubMed 29659470Ge B, Wu M, Chen Q, Chen Q, Lin R, Liu L, Huang Q. A prospective randomized controlled trial of laparoscopic repair versus open repair for perforated peptic ulcers. Surgery. 2016 Feb;159(2):451-8. doi: 10.1016/j.surg.2015.07.021. Epub 2015 Aug 19.
PubMed 26297055Siow SL, Mahendran HA, Wong CM, Hardin M, Luk TL. Laparoscopic versus open repair of perforated peptic ulcer: Improving outcomes utilizing a standardized technique. Asian J Surg. 2018 Mar;41(2):136-142. doi: 10.1016/j.asjsur.2016.11.004. Epub 2016 Dec 7.
PubMed 27955872
Study at a glance
From the registry record, last updated by the sponsor on 29 Dec 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison Between Laparoscopic and Open Repair of Perforated Gastroduodenal Peptic Ulcer
- ClinicalTrials.gov ID
- NCT04447170
- Acronym / sponsor ID
- LOREPUP / I-Go-GIPS_2020_1
- Conditions
- Surgery, Emergencies, Peptic Ulcer Perforation
- Keywords
- Peptic ulcer perforation, Laparoscopy
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 200 participants (estimated)
- Lead sponsor
- Gianluca CostaUniversity, hospital or other
- Study start
- 1 Jan 2017 (actual)
- Primary completion
- 30 Nov 2021 (actual)
- Study completion
- 1 Apr 2022 (estimated)
- First posted
- 25 Jun 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Although laparoscopic repair (LR) of perforated peptic ulcers (PPUs) has long been accepted, clinical evidence comparing LR versus open repair (OR) remains lacking. The aim of this study is to evaluate the feasibility, safety and outcome of laparoscopic gastric repair and compare it with the outcome open repair by relying on a propensity score matching statistical technique
Detailed description
Despite the evolution of medical management of Gastroduodenal Peptic Ulcer (GPU), complications like bleeding and perforation are still not uncommon in clinical practice. According to the literature in average, 2-14% of peptic ulcers result in perforation, most 215 commonly occurring in females over the age of 60 and chronic NSAID, alcohol or tobacco users.
Management of perforated peptic ulcer entails resuscitation, pharmacotherapy and surgery.
Traditionally, suture with or without omental patch has been considered the 'gold standard' and still is. It is associated with shorter length of stay, lower transfusion needs and has lower morbidity as compared to gastrectomy. In 1992, it has been proposed that laparoscopy should be routinely considered in the management of perforated duodenal ulcer. Nowadays due to the advances in laparoscopic technique, many publications suggest that laparoscopic repair of perforated peptic ulcers could be a superior choice to open repair. These is linked with the advantages of laparoscopic surgery over open surgery such as reduced postoperative pain, lower wound infection rate, decreased length of hospital stay, and earlier functional recovery
Study design
- Observational model
- Case-control
- Time perspective
- Other
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Laparoscopic repair | – | Procedure: Simple repair or Graham techniquePatients undergoing laparoscopic treatment |
| Open repair | – | –Patients undergoing open treatment |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Multicenter italian national case-control study
Key inclusion criteria (1 listed)
- Patients surgically treated for benign peptic ulcer perforation
Key exclusion criteria (5 listed)
- Age < 18 years
- Pregnant and breastfeeding women
- Malignant ulcer perforation
- Gastric resection
- Diagnostic laparoscopy/laparotomy with no further surgical procedures performed
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Simple repair or Graham techniqueSimple suture with or without omental protective patch | Procedure or surgery | Laparoscopic repair |
Primary outcome
30-day Mortality Rate
Time frame: 18 months
30-day Morbidity Rate
Time frame: 18 months
Morbidity defined by mean of the most used classification scoring system
7 secondary outcomes
Conversion rate
Time frame: 18 months
Calculation of Boey index
Time frame: 18 months
Calculation of Mannheim Peritonitis Index
Time frame: 18 months
Calculation of Shock index
Time frame: 18 months
Calculation of Age-related shock index
Time frame: 18 months
Operative time
Time frame: 18 months
Calculation of Charlson Age-Comorbidity Index (CACI)
Time frame: 18 months
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Dec 2021.
- Background: PubMed 29659470Cirocchi R, Soreide K, Di Saverio S, Rossi E, Arezzo A, Zago M, Abraha I, Vettoretto N, Chiarugi M. Meta-analysis of perioperative outcomes of acute laparoscopic versus open repair of perforated gastroduodenal ulcers. J Trauma Acute Care Surg. 2018 Aug;85(2):417-425. doi: 10.1097/TA.0000000000001925.
- Results publication: PubMed 26297055Ge B, Wu M, Chen Q, Chen Q, Lin R, Liu L, Huang Q. A prospective randomized controlled trial of laparoscopic repair versus open repair for perforated peptic ulcers. Surgery. 2016 Feb;159(2):451-8. doi: 10.1016/j.surg.2015.07.021. Epub 2015 Aug 19.
- Results publication: PubMed 27955872Siow SL, Mahendran HA, Wong CM, Hardin M, Luk TL. Laparoscopic versus open repair of perforated peptic ulcer: Improving outcomes utilizing a standardized technique. Asian J Surg. 2018 Mar;41(2):136-142. doi: 10.1016/j.asjsur.2016.11.004. Epub 2016 Dec 7.
Related trials for Surgery
Active, not recruiting
Shockwave™ vs Surgical Endarterectomy for Calcified Severe Common Femoral Artery Stenosis: Comparison of Efficacy, Safety and Long-Term Outcomes
Common Femoral Artery Stenosis, Calcification; Heart
RecruitingObservational study
Comparison of Hemodynamic Responses During Anesthesia Induction Using Eleveld and Schnider
Spinal (Fusion) Surgery, Total Intravenous Anesthesia
RecruitingPhase 1
Serial Amnioinfusions as Regenerative Therapy for Pulmonary Hypoplasia
Renal Failure Congenital, Congenital Renal Anomaly Nos
RecruitingPhase 2
Proton Spatially Fractionated Radiotherapy or Photon Stereotactic Body Radiotherapy in Combination With Pembrolizumab Before Surgery for the Treatment of Locally Advanced and Radiation-Naive Locoregionally Recurrent Oral Cavity Cancer, OSPRI Trial
Locally Advanced Oral Cavity Squamous Cell Carcinoma, Locally Recurrent Oral Cavity Squamous Cell Carcinoma
RecruitingPhase 2/3
Testing the Role of DNA Released From Tumor Cells Into the Blood in Guiding the Use of Immunotherapy After Surgical Removal of the Bladder, Kidney, Ureter, and Urethra for Urothelial Cancer Treatment, MODERN Study
Muscle Invasive Bladder Urothelial Carcinoma, Muscle Invasive Renal Pelvis Urothelial Carcinoma
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
13 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Surgery and Emergencies, run by Gianluca Costa at 13 sites in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 29 Dec 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 13 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Gianluca Costa, MD, PhD (00393921119067, gianlucacostaphd@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
30-day Mortality Rate (time frame: 18 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04447170, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Dec 2021; AzTrials last refreshed its copy on 7 Nov 2026.