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Intraoperative colonic lavage with primary anastomosis vs. Hartmann's procedure for perforated diverticular disease of the colon: a consecutive study.
Hepatogastroenterology. 2002 May-Jun; 49(45):664-7.H

Abstract

BACKGROUND/AIMS

The ideal treatment for complicated diverticulitis is still controversial. The Hartmann's procedure remains the favored option in patients with acute complicated sigmoid disease but there has been increasing interest in primary resection and anastomosis with intraoperative colonic lavage. A prospective study was carried out on 71 patients with peritonitis, comparing primary resection with intraoperative colonic lavage, and Hartmann's procedure.

METHODOLOGY

Between January 1994 and September 1999, 71 patients underwent emergency laparotomy for diverticular peritonitis. Primary resection and anastomosis with intraoperative colonic lavage was performed in 29 patients (group I) and Hartmann's procedure in 42 patients (group II). All data were collected on standardized forms.

RESULTS

There were no differences between the two groups according to clinical features, biology, severity of disease and operative delay. The mortality rate in group I and group II was, respectively, 7 and 10% (P = 0.6). The incidence of postoperative complication was higher after Hartmann's procedure (P < 0.05). The mean hospital stay was significantly longer for the Hartmann's procedure compared to primary resection with intraoperative colonic lavage.

CONCLUSIONS

Primary resection with intraoperative colonic lavage compares favorably with Hartmann's procedure for local or diffuse purulent peritonitis in complicated diverticulitis. It should be an alternative to the Hartmann's procedure in stercoral peritonitis.

Authors+Show Affiliations

C.H.U. Angers, Department of Visceral Surgery, 4 rue Larrey, 49033 Angers, France. nicoregenet@yahoo.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12063965

Citation

Regenet, N, et al. "Intraoperative Colonic Lavage With Primary Anastomosis Vs. Hartmann's Procedure for Perforated Diverticular Disease of the Colon: a Consecutive Study." Hepato-gastroenterology, vol. 49, no. 45, 2002, pp. 664-7.
Regenet N, Tuech JJ, Pessaux P, et al. Intraoperative colonic lavage with primary anastomosis vs. Hartmann's procedure for perforated diverticular disease of the colon: a consecutive study. Hepatogastroenterology. 2002;49(45):664-7.
Regenet, N., Tuech, J. J., Pessaux, P., Ziani, M., Rouge, C., Hennekinne, S., & Arnaud, J. P. (2002). Intraoperative colonic lavage with primary anastomosis vs. Hartmann's procedure for perforated diverticular disease of the colon: a consecutive study. Hepato-gastroenterology, 49(45), 664-7.
Regenet N, et al. Intraoperative Colonic Lavage With Primary Anastomosis Vs. Hartmann's Procedure for Perforated Diverticular Disease of the Colon: a Consecutive Study. Hepatogastroenterology. 2002 May-Jun;49(45):664-7. PubMed PMID: 12063965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraoperative colonic lavage with primary anastomosis vs. Hartmann's procedure for perforated diverticular disease of the colon: a consecutive study. AU - Regenet,N, AU - Tuech,J J, AU - Pessaux,P, AU - Ziani,M, AU - Rouge,C, AU - Hennekinne,S, AU - Arnaud,J P, PY - 2002/6/18/pubmed PY - 2002/11/26/medline PY - 2002/6/18/entrez SP - 664 EP - 7 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 49 IS - 45 N2 - BACKGROUND/AIMS: The ideal treatment for complicated diverticulitis is still controversial. The Hartmann's procedure remains the favored option in patients with acute complicated sigmoid disease but there has been increasing interest in primary resection and anastomosis with intraoperative colonic lavage. A prospective study was carried out on 71 patients with peritonitis, comparing primary resection with intraoperative colonic lavage, and Hartmann's procedure. METHODOLOGY: Between January 1994 and September 1999, 71 patients underwent emergency laparotomy for diverticular peritonitis. Primary resection and anastomosis with intraoperative colonic lavage was performed in 29 patients (group I) and Hartmann's procedure in 42 patients (group II). All data were collected on standardized forms. RESULTS: There were no differences between the two groups according to clinical features, biology, severity of disease and operative delay. The mortality rate in group I and group II was, respectively, 7 and 10% (P = 0.6). The incidence of postoperative complication was higher after Hartmann's procedure (P < 0.05). The mean hospital stay was significantly longer for the Hartmann's procedure compared to primary resection with intraoperative colonic lavage. CONCLUSIONS: Primary resection with intraoperative colonic lavage compares favorably with Hartmann's procedure for local or diffuse purulent peritonitis in complicated diverticulitis. It should be an alternative to the Hartmann's procedure in stercoral peritonitis. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/12063965/Intraoperative_colonic_lavage_with_primary_anastomosis_vs__Hartmann's_procedure_for_perforated_diverticular_disease_of_the_colon:_a_consecutive_study_ L2 - http://www.diseaseinfosearch.org/result/2310 DB - PRIME DP - Unbound Medicine ER -