Hartmann’s Procedure for Complicated Diverticulitis: A Critical Reappraisal

Costantini, Raffaele

doi:10.2174/2589645801913010121

Cited by 2 publications

(1 citation statement)

References 78 publications

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“…As expected from the literature data (DIVA arm of the LADIES Trial study 6,16 , WSES guidelines 4 , Uematsu et al 19 and some meta-analyses 17,18,20,21 ), patients in the PA group had a Charlson Comorbidity Index and an ASA score lower than the HP group.…”

Section: Discussionmentioning

confidence: 54%

Surgical Decision-making for the Treatment of Acute Diverticulitis: a Single-centre Retrospective Study

Inversini,

Adla,

Vigezzi

et al. 2023

Preprint

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BACKGROUND: Several studies suggest that laparoscopic peritoneal lavage might be associated with an increased event rate. The WSES guidelines recommend performing laparoscopic peritoneal lavage only in highly selected patients; however, selection criteria remain poorly described. OBJECTIVE: This study aimed to assess the complication and long-term outcomes of the lavage group, and to report our experience of acute diverticulitis. DESIGN: This was based on a retrospective cohort study. SETTINGS: This was a study conducted in Fondazione Macchi, Italy. PATIENTS: Patients presenting with acute diverticulitis and undergoing surgery in the hospital of Varese between 2018 and 2022 were included. INTERVENTION: Operative management of acute sigmoid diverticulitis was involved, in particular laparoscopic peritoneal lavage, primary resection and the Hartmann procedure. MAIN OUTCOME MEASURES: The main outcome measures were short-term and long-term outcomes. RESULTS: Long-term follow-up showed the occurrence of complications Clavien-Dindo ≥ 2 in 21.9% (16/73) of patients in the sigmoidectomy group versus 61.1% (11/18) of patients in the lavage group. Among the 11 patients complicated after laparoscopic lavage, 9 required a second surgery. After a comparison between the complicated and uncomplicated patients who were managed with laparoscopic lavage, descriptive differences were found regarding the BMI (95% CI, 21.7-24.3 vs 95% CI, 24.7-31.3, p=0.0419). In analysis, BMI ≥ 27 Kg/m2 (OR, 16 p=0.049) was associated with short and long-term complications in the lavage group. There was no evidence for an association between complications and BMI ≥ 27 Kg/m2 in the primary resection (OR, 1.61 p=1) and the Hartmann procedure group (OR, 4.25 p=0.1438). LIMITATIONS: The study was limited by its retrospective nature and small sample size. CONCLUSIONS: Perforated colonic diverticulitis treated with laparoscopic peritoneal lavage was associated with a high morbidity rate; however, BMI could be a prognostic factor for long-term outcomes, including recurrent diverticulitis and the occurrence of abscesses.

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Section: Discussionmentioning

confidence: 54%

Surgical Decision-making for the Treatment of Acute Diverticulitis: a Single-centre Retrospective Study

Inversini,

Adla,

Vigezzi

et al. 2023

Preprint

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Pain from Internal Organs and Headache: The Challenge of Comorbidity

Affaitati,

Costantini,

Fiordaliso

et al. 2024

Diagnostics

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Headache and visceral pain are common clinical painful conditions, which often co-exist in the same patients. Numbers relative to their co-occurrence suggest possible common pathophysiological mechanisms. The aim of the present narrative review is to describe the most frequent headache and visceral pain associations and to discuss the possible underlying mechanisms of the associations and their diagnostic and therapeutic implications based on the most recent evidence from the international literature. The conditions addressed are as follows: visceral pain from the cardiovascular, gastrointestinal, and urogenital areas and primary headache conditions such as migraine and tension-type headache. The most frequent comorbidities involve the following: cardiac ischemic pain and migraine (possible shared mechanism of endothelial dysfunction, oxidative stress, and genetic and hormonal factors), functional gastrointestinal disorders, particularly IBS and both migraine and tension-type headache, primary or secondary dysmenorrhea and migraine, and painful bladder syndrome and headache (possible shared mechanisms of peripheral and central sensitization processes). The data also show that the various visceral pain–headache associations are characterized by more than a simple sum of symptoms from each condition but often involve complex interactions with the frequent enhancement of symptoms from both, which is crucial for diagnostic and treatment purposes.

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Hartmann’s Procedure for Complicated Diverticulitis: A Critical Reappraisal

Cited by 2 publications

References 78 publications

Surgical Decision-making for the Treatment of Acute Diverticulitis: a Single-centre Retrospective Study

Surgical Decision-making for the Treatment of Acute Diverticulitis: a Single-centre Retrospective Study

Pain from Internal Organs and Headache: The Challenge of Comorbidity

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