Background: The standard treatment for Hinchey III perforated diverticulitis with peritonitis was resection with or without a stoma, but recent trials have shown that laparoscopic lavage is a reasonable alternative. This registry-based Swedish study investigated results at a national level to assess safety in real-world scenarios.
Methods: Patients in Sweden who underwent emergency surgery for perforated diverticulitis between 2016 and 2018 were studied. Inverse probability weighting by propensity score was used to adjust for confounding factors.
Results: A total of 499 patients were included in this study. Laparoscopic lavage was associated with a significantly lower 90-day Comprehensive Complication Index (20.9 versus 32.0; odds ratio 0.77, 95 per cent compatibility interval (c.i.) 0.61 to 0.97) and overall duration of hospital stay (9 versus 15 days; ratio of means 0.84, 95 per cent c.i. 0.74 to 0.96) compared with resection. Patients had 82 (95 per cent c.i. 39 to 140) per cent more readmissions following lavage than resection (27.2 versus 21.0 per cent), but similar reoperation rates. More co-morbidity was noted among patients who underwent resection than those who had laparoscopic lavage.
Conclusion: Laparoscopic lavage is safe in routine care beyond trial evaluations.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/bjs/znab211 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictive tool for the risk of hypothermia during laparoscopic gynecologic tumor resection.
Eur J Obstet Gynecol Reprod Biol
January 2025
Department of Anesthesiology, Liuzhou Maternal and Child Health Hospital, Liuzhou 545001, Guangxi, China.
Objective: Based on the machine learning algorithm, construct a hypothermia prediction model for gynecological tumor resection under laparoscopic general anesthesia.
Methods: This research conducted a retrospective analysis, gathering data from individuals who had undergone minimally invasive surgical procedures for gynecological tumors in a Chinese Hospital, ranging from June 2018 to August 2024. During this timeframe, a total of 308 cases were examined for analysis, with 70% of the cases allocated to the modeling dataset and the remaining 30% designated for the validation dataset.
Managing Leaks and Fistulas After Laparoscopic Sleeve Gastrectomy: Challenges and Solutions.
Clin Exp Gastroenterol
January 2025
Department of Surgery, Mount Sinai Hospital, New York, NY, USA.
Postoperative leaks after sleeve gastrectomy are a troublesome complication that occur in 0.7-5.3% of cases depending on the referenced source.
View Article and Find Full Text PDFGallbladder perforation causing local peritonitis in left upper abdomen: A case report.
Int J Surg Case Rep
January 2025
Department of Surgery, Osaka City Juso Hospital, Osaka, Japan.
Introduction And Importance: Type 1 gallbladder perforation (GBP) in the free abdominal cavity causes pan-peritonitis, which is both rare and difficult to diagnose.
Case Presentation: An 80-year-old man presented to our hospital with acute left upper abdominal pain. Twenty days prior to presentation, he had been admitted for 12 days with coronavirus disease 2019 (COVID-19).
Introduction: To investigate the current evidence regarding long-term outcomes using laparoscopic peritoneal lavage (LPL) versus primary bowel resection (PR) in Hinchey III diverticulitis.
Methods: A systematic review was undertaken based upon articles published between 1st January 2000 and 1st March 2024. Databases Pubmed, Scopus and Embase were used employing the key search terms "diverticulitis" and "peritoneal lavage".
EAES rapid guideline: surgical management of complicated diverticulitis - with ESCP participation.
Surg Endosc
December 2024
Cancer Center Amsterdam, Amsterdam, Netherlands.
Background: The surgical management of complicated diverticulitis varies across Europe. EAES members prioritized this topic to be addressed by a clinical practice guideline through an online questionnaire.
Objective: To develop evidence-informed clinical practice recommendations for key stakeholders involved in the treatment of complicated diverticulitis; to improve operative and perioperative outcomes, patient experience and quality of life through a systematic evidence-to-decision approach by a diverse, multidisciplinary panel.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!