Damage control surgery in perforated diverticulitis: ongoing peritonitis at second surgery predicts a worse outcome

Sohn, Maximilian; Agha, Ayman; Steiner, Phillip; Hochrein, Alfred; Komm, M.; Ruppert, R.; Ritschl, Paul Viktor; Aigner, Felix; Iesalnieks, Igors

doi:10.1007/s00384-018-3025-7

Cited by 22 publications

(24 citation statements)

References 28 publications

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“…Several studies have addressed the intestinal continuity during surgical treatment for acute diverticulitis. There are three cohort studies and four randomized trials [116][117][118][119][140][141][142]. The randomized clinical trials all include a diverting loop ileostomy in the primary anastomosis arm.…”

Section: What Is the Role Of Restoration Of Intestinal Continuity Witmentioning

confidence: 99%

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

184

177

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Aim The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than 90% agreement was considered a consensus. The final phrasing of the statements with < 90% agreement was discussed in a consensus meeting at the ESCP annual meeting in Vienna in September 2019. Thereafter, the first and the last author drafted the final text of the guideline and circulated it for final approval and for a third and final online voting of rephrased statements. Results This guideline contains 38 evidence based consensus statements on the management of diverticular disease. Conclusion This international, multidisciplinary guideline provides an up to date summary of the current knowledge of the management of diverticular disease as a guidance for clinicians and patients.

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Section: What Is the Role Of Restoration Of Intestinal Continuity Witmentioning

confidence: 99%

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

184

177

View full text Add to dashboard Cite

show abstract

“…In a recent update of their results, Sohn et al 4 confirmed the benefits of DCS. However, in our opinion, an incorrect selection of patients persisted.…”

mentioning

confidence: 88%

“…Only 22% of DCS patients (16/74) met severe septic shock criteria. 4 We do not agree with the authors’ choice to subject the remaining non-septic population (78%; 58/74) to DCS, a complex surgical procedure for real emergency situations.…”

mentioning

confidence: 93%

“… 2 – 4 In the case of colonic diverticular perforation, DCS consists of a two-stage procedure: (first stage) perforated colon tract resection with blind oral and aboral closure, followed by lavage and temporary, vacuum-assisted abdominal wall closure; (second stage) scheduled second laparotomy after 24–48 hours with a decision about the definitive colon reconstruction (primary anastomosis with or without loop ileostomy vs Hartmann’s procedure). 2 – 4 In addition, further conditioning by continued bridging is possible with a vacuum dressing and definitive colon reconstruction after another 24–48 hours in the course of a possible “third look”. 2 – 4 Therefore, DCS should not be considered as a low invasiveness procedure.…”

mentioning

confidence: 99%

“… 2 – 4 In addition, further conditioning by continued bridging is possible with a vacuum dressing and definitive colon reconstruction after another 24–48 hours in the course of a possible “third look”. 2 – 4 Therefore, DCS should not be considered as a low invasiveness procedure. Moreover, we should keep in mind that DCS (in particular the “open abdomen”) is associated with significant morbidity and high costs.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Current treatment of acute perforated diverticulitis: the role of damage control surgery

Zizzo

Manenti

Ugoletti

2018

JIR

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Notfallmanagement der perforierten Sigmadivertikulitis und Blutung

2018

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Damage control surgery in perforated diverticulitis: ongoing peritonitis at second surgery predicts a worse outcome

Abstract: Ongoing peritonitis after DCS is a predictor of a worse outcome in patients with perforated diverticulitis. Enterococcal and fungal infections have a negative impact on occurrence of OP and overall outcome.

Cited by 22 publications

References 28 publications

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Current treatment of acute perforated diverticulitis: the role of damage control surgery

Notfallmanagement der perforierten Sigmadivertikulitis und Blutung

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