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

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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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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Surgery, Fuji City General Hospital, 50, Takashima-Cho, Fuji-Shi, Shizuoka, 417-8567, Japan

    Yuya Nyumura, Kazuto Tsuboi, Toshimasa Suzuki & Tetsuya Kajimoto

  2. Department of Gastrointestinal Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan

    Yuya Nyumura, Yuichiro Tanishima, Fumiaki Yano & Ken Eto

Authors
  1. Yuya Nyumura
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  2. Kazuto Tsuboi
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  3. Toshimasa Suzuki
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  4. Tetsuya Kajimoto
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  5. Yuichiro Tanishima
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  6. Fumiaki Yano
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  7. Ken Eto
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Contributions

YN: Conception, Methodology, Data collection and analysis, Writing the manuscript. KT: Data collection and analysis, Writing—reviewing. TS: Data collection and analysis. TK: Data collection and analysis. YT: Data analysis and interpretation. FY: Writing—review and editing. KE: Writing—review & editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yuya Nyumura.

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Conflict of interest

We have no relevant financial or nonfinancial interests to disclose.

Ethical approval

This study was approved by the Ethics Committee of our hospital (approval no. 212) [name blinded for peer review] and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

The requirement for informed consent from the patients was waived because the analysis was based on an anonymized retrospective record review.

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Nyumura, Y., Tsuboi, K., Suzuki, T. et al. Pathophysiology and surgical outcomes of patients with fungal peritonitis from upper gastrointestinal tract perforation: a retrospective study. Surg Today (2024). https://doi.org/10.1007/s00595-024-02851-9

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  • DOI: https://doi.org/10.1007/s00595-024-02851-9

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