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Surgery Today

30-04-2024 | Peritonitis | Original Article

Pathophysiology and surgical outcomes of patients with fungal peritonitis from upper gastrointestinal tract perforation: a retrospective study

Authors: Yuya Nyumura, Kazuto Tsuboi, Toshimasa Suzuki, Tetsuya Kajimoto, Yuichiro Tanishima, Fumiaki Yano, Ken Eto

Published in: Surgery Today

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Abstract

Purpose

To compare the pathophysiology and surgical outcomes of emergency surgery for upper gastrointestinal tract perforation with and without fungal peritonitis and identify the risk factors for fungal peritonitis.

Methods

The subjects of this retrospective study were patients with upper gastrointestinal perforation and peritonitis who underwent emergency surgery at a single medical center in Japan. The patients were allocated to two groups according to the presence or absence of fungal peritonitis: group F and group N, respectively.

Results

At the time of surgery, ascitic fluid culture or serum β-D glucan levels were available for 54 patients: 29 from group F and 25 from group N, respectively. The stomach was perforated in 14 patients (25.9%) and the duodenum was perforated in 40 patients (74.1%). Group F had a higher proportion of patients with low preoperative prognostic nutritional index scores (≤ 40) and C-reactive protein levels and a higher postoperative complication rate. The time to initiate food intake and the postoperative hospital stay were also significantly longer in group F. Multivariate analysis identified that the perforation site of the stomach was a risk factor for fungal peritonitis.

Conclusion

Patients with fungal peritonitis from upper gastrointestinal tract perforation had higher postoperative complication rates, delayed postoperative recovery, and a longer hospital stay. Gastric perforation was a risk factor for fungal peritonitis.
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Metadata
Title
Pathophysiology and surgical outcomes of patients with fungal peritonitis from upper gastrointestinal tract perforation: a retrospective study
Authors
Yuya Nyumura
Kazuto Tsuboi
Toshimasa Suzuki
Tetsuya Kajimoto
Yuichiro Tanishima
Fumiaki Yano
Ken Eto
Publication date
30-04-2024
Publisher
Springer Nature Singapore
Keyword
Peritonitis
Published in
Surgery Today
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-024-02851-9