Peritoneal Lavage in Complicated Acute Diverticulitis Back to the Future

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art_G_Peritoneal_Lavage_in_Complicated_Acute_Diverticulitis_Back_to_2016.PDF (104.92 KB)
Citações na Scopus
6
Tipo de produção
article
Data de publicação
2016
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
G, Ricardo Escalante
LIZCANO, Ana
M, Bernardo Acosta
Citação
JOURNAL OF CLINICAL GASTROENTEROLOGY, v.50, suppl.1, p.S83-S85, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Purpose: The aim of this study was to assess laparoscopic lavage in patients with acute diverticulitis. Background: In recent times, laparoscopic peritoneal lavage has been considered a therapeutic alternative to standard resection procedures. In Hinchey III diverticulitis there is the possibility of avoiding ostomies or resection procedures. Study: This retrospective study was conducted in a single-care institution. Results: Patients requiring emergency surgery for perforated diverticulitis and generalized peritonitis between March 2011 and May 2014 were identified from a prospective database. Seventy-two patients underwent surgery for diverticulitis. Forty-three patients presented with generalized peritonitis (Hinchey III) and 29 with gross fecal contamination (Hinchey IV). From the Hinchey III group, 17 patients (39.5%), with a median age of 56.8 years, were selected to undergo peritoneal lavage. Postoperative length of stay was 4.2 days, the rate of minor complications was 35%, that of major complications was 0%, and mortality rate was 0%. Over a median follow-up of 24.6 months none required reoperation. Conclusions: The number of patients selected for laparoscopic lavage in the management of perforated diverticulitis is increasing as it provides an alternative to Hartmann's procedure in emergency cases. This approach should be considered suitable for patients without important comorbidities, and only in centers experienced in laparoscopic surgery. It reduces the length of hospital stay. Morbidity and mortality are lower than in those in whom resection was considered necessary. Longer follow-up and results of other trials will be necessary to draw an adequate conclusion.
Palavras-chave
diverticulitis, Hartmann's procedure, peritoneal lavage, laparoscopic surgery
URI
https://observatorio.fm.usp.br/handle/OPI/17209
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Coleções
Artigos e Materiais de Revistas Científicas - FM/Outros
Artigos e Materiais de Revistas Científicas - ODS/03