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J Gehrman, E Angenete, I Björholt, D Bock, J Rosenberg, E Haglind
BACKGROUND: Open surgery with resection and colostomy (Hartmann's procedure) has been the standard treatment for perforated diverticulitis with purulent peritonitis. In recent years laparoscopic lavage has emerged as an alternative, with potential benefits for patients with purulent peritonitis, Hinchey grade III. The aim of this study was to compare laparoscopic lavage and Hartmann's procedure with health economic evaluation within the framework of the DILALA (DIverticulitis - LAparoscopic LAvage versus resection (Hartmann's procedure) for acute diverticulitis with peritonitis) trial...
October 2016: British Journal of Surgery
Sorena Afshar, Mohamed A Kurer
Five years ago we published a systematic review in Colorectal Disease on laparoscopic peritoneal lavage (LPL) for perforated diverticulitis (1). At the time several observational studies of this approach had been published, the largest of which by Myers et al reported impressive results (2). These studies suggested that LPL was a feasible and more conservative alternative to the Hartmann's procedure (HP), especially in Hinchey III. However, the inherent selection bias in these non-randomised studies meant that randomised trials were required...
June 1, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Manu Kaushik, Jasneet Singh Bhullar, Sandiya Bindroo, Hemindermeet Singh, Vijay K Mittal
BACKGROUND: Diverticulitis is a common condition which carries significant morbidity and socioeconomic burden (McGillicuddy et al in Arch Surg 144:1157-1162, 2009). The surgical management of diverticulitis has undergone significant changes in recent years. This article reviews the role of minimally invasive approach in management of complicated diverticulitis, with a focus on recent concepts and advances. MATERIALS AND METHODS: A literature review of past 10 years (January 2004 to September 2014) was performed using the electronic database MEDLINE from PubMed which included articles only in English...
March 2016: Digestive Diseases and Sciences
Cecilia Ponzano, Cristiano Germano Sigismondo Hüscher, Diletta Overi
No abstract text is available yet for this article.
April 24, 2015: Annals of Surgery
Eva Angenete, Anders Thornell, Jakob Burcharth, Hans-Christian Pommergaard, Stefan Skullman, Thue Bisgaard, Per Jess, Zoltan Läckberg, Peter Matthiessen, Jane Heath, Jacob Rosenberg, Eva Haglind
OBJECTIVE: To evaluate short-term outcomes of a new treatment for perforated diverticulitis with purulent peritonitis in a randomized controlled trial. BACKGROUND: Perforated diverticulitis with purulent peritonitis (Hinchey III) has traditionally been treated with surgery including colon resection and stoma (Hartmann procedure) with considerable postoperative morbidity and mortality. Laparoscopic lavage has been suggested as a less invasive surgical treatment. METHODS: Laparoscopic lavage was compared with colon resection and stoma in a randomized controlled multicenter trial, DILALA (ISRCTN82208287)...
January 2016: Annals of Surgery
F D McDermott, D Collins, A Heeney, D C Winter
BACKGROUND: The severity of acute diverticulitis ranges from mild, simple inflammation to pericolic abscesses, or perforation with faeculent peritonitis. Treatment of diverticulitis has evolved towards more conservative and minimally invasive strategies. The aim of this review is to highlight recent concepts and advances in management. METHODS: A literature review was performed on the electronic databases MEDLINE from PubMed, Embase and the Cochrane Library for publications in English...
January 2014: British Journal of Surgery
Anders Thornell, Eva Angenete, Elisabeth Gonzales, Jane Heath, Per Jess, Zoltan Läckberg, Henrik Ovesen, Jacob Rosenberg, Stefan Skullman, Eva Haglind
BACKGROUND: Perforated diverticulitis is a condition associated with substantial morbidity. Recently published reports suggest that laparoscopic lavage has fewer complications and shorter hospital stay. So far no randomised study has published any results. METHODS: DILALA is a Scandinavian, randomised trial, comparing laparoscopic lavage (LL) to the traditional Hartmann's Procedure (HP). Primary endpoint is the number of re-operations within 12 months. Secondary endpoints consist of mortality, quality of life (QoL), re-admission, health economy assessment and permanent stoma...
2011: Trials
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