Laparoscopic Lavage for Perforated Diverticulitis With Purulent Peritonitis: A Randomized Trial

Annals of Internal Medicine
Anders ThornellEva Haglind

Abstract

Perforated diverticulitis with purulent peritonitis has traditionally been treated with open colon resection and stoma formation with risk for reoperations, morbidity, and mortality. Laparoscopic lavage alone has been suggested as definitive treatment. To compare laparoscopic lavage with open colon resection and colostomy (Hartmann procedure) for perforated diverticulitis with purulent peritonitis. Randomized, controlled, multicenter, open-label trial. (ISRCTN registry number: ISRCTN82208287). 9 hospitals in Sweden and Denmark. Patients who have confirmed Hinchey grade III perforated diverticulitis with purulent peritonitis at diagnostic laparoscopy. Randomization between laparoscopic lavage and the Hartmann procedure. Primary outcome was the percentage of patients having 1 or more reoperations within 12 months. Key secondary outcomes were number of reoperations, hospital readmissions, total length of hospital stay during 12 months, and adverse events. A total of 43 and 40 patients were randomly assigned to laparoscopic lavage and the Hartmann procedure with a median (first, third quartiles) follow-up of 372 days (336, 394) and 378 days (226, 396), respectively. Fewer patients in the laparoscopic group (12 of 43; 27.9%) than in...Continue Reading

Associated Clinical Trials

Citations

Aug 20, 2016·Scandinavian Journal of Gastroenterology·Kjetil SøreideGeorge C Velmahos
Aug 29, 2016·International Journal of Colorectal Disease·Eva AngeneteEva Haglind
Sep 16, 2016·Annals of Surgery·James R MarshallTimothy W Eglinton
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May 10, 2020·Diseases of the Colon and Rectum·Jason HallUNKNOWN Prepared on behalf of the Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons
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