Dataset Information

Acute laparoscopic and open sigmoidectomy for perforated diverticulitis: a propensity score-matched cohort.

ABSTRACT:

Background

Hartmann's procedure for perforated diverticulitis can be characterised by high morbidity and mortality rates. While the scientific community focuses on laparoscopic lavage as an alternative for laparotomy, the option of laparoscopic sigmoidectomy seems overlooked. We compared morbidity and hospital stay following acute laparoscopic sigmoidectomy (LS) and open sigmoidectomy (OS) for perforated diverticulitis.

Methods

This retrospective cohort parallel to the Ladies trial included patients from 28 Dutch academic or teaching hospitals between July 2010 and July 2014. Patients with LS were matched 1:2 to OS using the propensity score for age, gender, previous laparotomy, CRP level, gastrointestinal surgeon, and Hinchey classification.

Results

The propensity-matched cohort consisted of 39 patients with LS and 78 patients with OS, selected from a sample of 307 consecutive patients with purulent or faecal perforated diverticulitis. In both groups, 66 % of the patients had Hartmann's procedure and 34 % had primary anastomosis. The hospital stay was shorter following LS (LS 7 vs OS 9 days; P = 0.016), and the postoperative morbidity rate was lower following LS (LS 44 % vs OS 66 %; P = 0.016). Mortality was low in both groups (LS 3 % vs OS 4 %; P = 0.685). The stoma reversal rate after Hartmann's procedure was higher following laparoscopy, with a probability of being stoma-free at 12 months of 88 and 62 % in the laparoscopic and open groups, respectively (P = 0.019). After primary anastomosis, the probability of reversal was 100 % in both groups.

Conclusions

In this propensity score-matched cohort, laparoscopic sigmoidectomy is superior to open sigmoidectomy for perforated diverticulitis with regard to postoperative morbidity and hospital stay.

SUBMITTER: Vennix S

PROVIDER: S-EPMC4992031 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Publications

Acute laparoscopic and open sigmoidectomy for perforated diverticulitis: a propensity score-matched cohort.

Vennix Sandra S Lips Daniel J DJ Di Saverio Salomone S van Wagensveld Bart A BA Brokelman Walter J WJ Gerhards Michael F MF van Geloven Anna A AA van Dieren Susan S Lange Johan F JF Bemelman Willem A WA

Surgical endoscopy 20151217 9

<h4>Background</h4>Hartmann's procedure for perforated diverticulitis can be characterised by high morbidity and mortality rates. While the scientific community focuses on laparoscopic lavage as an alternative for laparotomy, the option of laparoscopic sigmoidectomy seems overlooked. We compared morbidity and hospital stay following acute laparoscopic sigmoidectomy (LS) and open sigmoidectomy (OS) for perforated diverticulitis.<h4>Methods</h4>This retrospective cohort parallel to the Ladies tria ...[more]

PMID: 26679173

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Dataset Information

Acute laparoscopic and open sigmoidectomy for perforated diverticulitis: a propensity score-matched cohort.

Background

Methods

Results

Conclusions

Publications

Acute laparoscopic and open sigmoidectomy for perforated diverticulitis: a propensity score-matched cohort.

Similar Datasets

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