Primary Anastomosis Better Than Hartmann's Procedure for Treating Perforated Diverticulitis Primary Anastomosis Better Than Hartmann's Procedure for Treating Perforated Diverticulitis

For stable patients with perforated diverticulitis and peritonitis, sigmoidectomy with primary anastomosis provides better outcomes than does Hartmann's procedure, according to results from the LADIES trial.Reuters Health Information
Source: Medscape General Surgery Headlines - Category: Surgery Tags: Gastroenterology News Source Type: news

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Authors: Costi R, Annicchiarico A, Morini A, Romboli A, Zarzavadjian Le Bian A, Violi V Abstract Acute diverticulitis (AD) is an increasing issue for health systems worldwide. As accuracy of clinical symptoms and laboratory examinations is poor, a pivotal role in preoperative diagnosis and severity assessment is played by CT scan. Several new classifications trying to adapt the intraoperative Hinchey's classification to preoperative CT findings have been proposed, but none really entered clinical practice. Treatment of early AD is mostly conservative (antibiotics) and may be administered in outpatients in selected ...
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research
CONCLUSION: Primary anastomosis is more cost-effective than Hartmann's procedure for perforated diverticulitis with purulent or faecal peritonitis. PMID: 32521053 [PubMed - as supplied by publisher]
Source: The British Journal of Surgery - Category: Surgery Authors: Tags: Br J Surg Source Type: research
ConclusionAlthough between-study heterogeneity needs to be taken into account, the present results indicate that primary anastomosis seems to be the preferred option over Hartmann ’s procedure in selected patients with Hinchey III or IV diverticulitis.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
AbstractBackgroundRight-sided colonic diverticulitis represents less than 5% of diverticulitis cases in North America. The purpose of this study was to describe the management and outcomes for patients with a first episode of right-sided diverticulitis in a North American center.MethodsThis was a retrospective cohort study, including all patients managed for right-sided diverticulitis at a single tertiary-care institution from 2000 to 2017. Patient demographics, disease characteristics, and treatment strategies were described. Short- (emergency surgery, operative morbidity, treatment failure) and long-term (recurrence, ele...
Source: World Journal of Surgery - Category: Surgery Source Type: research
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
Abstract Acute diverticulitis is an emergency surgical condition that is commonly managed via an acute surgical unit model. Operative surgery is indicated in selected situations including generalized peritonitis or fistulous disease; however, limited data exist on how borderline patients potentially needing surgery may be salvaged by close clinical management with modern interventional techniques. The aims of the study were to identify the operative surgery rates in acute diverticulitis and predictors for identifying patients with complicated diverticulitis. Retrospective data collection was performed on a prospec...
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
SummaryBackgroundThe surgical management of perforated sigmoid diverticulitis (PSD) is controversial and challenging. Hartmann ’s procedure (HP) still remains the most frequently performed procedure for diffuse peritonitis. However, because less than 50% of patients never achieve restored bowel continuity, alternative surgical procedures have been proposed, including laparoscopic lavage and resection with primary anastomo sis (PRA), with or without a covering ileostomy. We performed a retrospective study to compare HP vs. PRA with loop-ileostomy for the treatment of PSD with generalized peritonitis.MethodsD...
Source: European Surgery - Category: Surgery Source Type: research
This study aimed to meta-analyse trials comparing primary resection and anastomosis (PRA) to Hartmann ’s procedure (HP) for Hinchey III/IV diverticulitis.MethodsA systematic literature search was conducted to identify observational studies and randomised control trials (RCTs) of patients with Hinchey III/IV diverticulitis undergoing sigmoidectomy that compared PRA to HP. The methodological quality of the included studies was assessed systematically (Newcastle –Ottawa, Jadad and Cochrane risk of bias scores) and a meta-analysis was performed.ResultsAfter removal of duplicates, 12 studies including 4 RCTs were id...
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
AbstractBackgroundEpidemiological studies show an increasing trend of hospitalization for acute diverticulitis (AD), but data regarding the trend in hospitalization for complicated AD in Italy are scarce. The aim of this study was to analyze the Italian trend in hospitalization for complicated AD, from 2008 to 2015.MethodsUsing the Italian Hospital Information System, we identified all patients with complicated colonic AD as a discharge diagnosis. Age- and sex-specific rates for AD as well as type of hospital admission (emergency/elective), type of complication (peritonitis, obstruction, bleeding, abscess, fistula, perfora...
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
Condition:   Perforated Diverticulitis Intervention:   Procedure: Damage control strategy Sponsors:   Städtisches Klinikum München GmbH;   Charite University, Berlin, Germany;   Medical University Innsbruck;   University of Pisa;   Cardarelli Hospital Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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