Laparoscopic peritoneal lavage (LPL) has recently been emerging as an effective alternative to laparoscopic sigmoidectomy (LS) in patients with complicated acute diverticulitis (CAD) (Modified Hinchey's classification grade II non-responder to conservative therapy and grade III). Aim of the study is to evaluate which surgical strategy, between LPL and LS, could give better results in patients with CAD
In the literature, there is no consensus about the role of the laparoscopic peritoneal lavage in the management of complicated acute diverticulitis. Recently, three important prospective randomized-control studies (SCANDIV, LOLA, DILALA) have reported contradicting conclusions, as two of them (SCANDIV and LOLA) state that LPL is not superior to sigmoidectomy for the high reoperation rate and morbidity, while DILALA confirms that LPL is feasible and safe in the short-term. To our knowledge, no international guidelines promote the use of LPL in complicated acute diverticulitis. We believe this technique could be safely used in a selected cohort of patients and, in some circumstances, could represent a "bridge" to a possible planned resection. The aim of the study is to collect and analyze the multicentric data of the LPL and LS and give a substantial contribution to the scientific community about this very debated topic.
Study Type
OBSERVATIONAL
Enrollment
66
LPL is done by irrigation with at least 6 L of warm saline throughout the abdominal cavity and after that, putting a drain in Douglas cavity through the port sites
Azienda Ospedaliero, Universitaria Pisana
Pisa, Tuscany, Italy
Short-term Morbidity
Time frame: 30 days
Short-term Mortality
Time frame: 30 days
Optimal Sepsis Control
Time frame: 30 days
Post-operative Re-interventions Rate
Time frame: 15 days
Mean Postoperative Time
Time frame: 1 day
Average Length of Postoperative Hospital Stay
Time frame: 30 day
Recurrent Colonic Diverticulitis Rate
Time frame: 6 months
Incisional Hernia Rate
Time frame: 6 months
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