Details

Autor(en) / Beteiligte

• Sneiders, D.
• Lambrichts, D. P. V.
• Swank, H. A.
• Blanken‐Peeters, C. F. J. M.
• Nienhuijs, S. W.
• Govaert, M. J. P. M.
• Gerhards, M. F.
• Hoofwijk, A. G. M.
• Bosker, R. J. I.
• Bilt, J. D. W.
• Heijnen, B. H. M.
• Cate Hoedemaker, H. O.
• Kleinrensink, G. J.
• Lange, J. F.
• Bemelman, W. A.

Titel

Long‐term follow‐up of a multicentre cohort study on laparoscopic peritoneal lavage for perforated diverticulitis

Ist Teil von

• Colorectal disease, 2019-06, Vol.21 (6), p.705-714

Ort / Verlag

England: Wiley Subscription Services, Inc

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• Aim Laparoscopic peritoneal lavage has increasingly been investigated as a promising alternative to sigmoidectomy for perforated diverticulitis with purulent peritonitis. Most studies only reported outcomes up to 12 months. Therefore, the objective of this study was to evaluate long‐term outcomes of patients treated with laparoscopic lavage. Methods Between 2008 and 2010, 38 patients treated with laparoscopic lavage for perforated diverticulitis in 10 Dutch teaching hospitals were included. Long‐term follow‐up data on patient outcomes, e.g. diverticulitis recurrence, reoperations and readmissions, were collected retrospectively. The characteristics of patients with recurrent diverticulitis or complications requiring surgery or leading to death, categorized as ‘overall complicated outcome’, were compared with patients who developed no complications or complications not requiring surgery. Results The median follow‐up was 46 months (interquartile range 7–77), during which 17 episodes of recurrent diverticulitis (seven complicated) in 12 patients (32%) occurred. Twelve patients (32%) required additional surgery with a total of 29 procedures. Fifteen patients (39%) had a total of 50 readmissions. Of initially successfully treated patients (n = 31), 12 (31%) had recurrent diverticulitis or other complications. At 90 days, 32 (84%) patients were alive without undergoing a sigmoidectomy. However, seven (22%) of these patients eventually had a sigmoidectomy after 90 days. Diverticulitis‐related events occurred up to 6 years after the index procedure. Conclusion Long‐term diverticulitis recurrence, re‐intervention and readmission rates after laparoscopic lavage were high. A complicated outcome was also seen in patients who had initially been treated successfully with laparoscopic lavage with relevant events occurring up to 6 years after initial surgery.