Trial reportThe British journal of surgery2017
Cost analysis of laparoscopic lavage compared with sigmoid resection for perforated diverticulitis in the Ladies trial.
Trial report in The British journal of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- EAES rapid guideline: surgical management of complicated diverticulitis - with ESCP participation.Surgical endoscopy · 2025Guideline
- Laparoscopic Lavage in the Management of Perforated Diverticulitis: a Contemporary Meta-analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Pooled it
- Cost-effectiveness of sigmoid resection with primary anastomosis or end colostomy for perforated diverticulitis: an analysis of the randomized Ladies trial.The British journal of surgery · 2020Trial
- Two-year results of the randomized clinical trial DILALA comparing laparoscopic lavage with resection as treatment for perforated diverticulitis.The British journal of surgery · 2018Trial
- Laparoscopic lavage: an option for surgical management of complicated diverticulitis.Surgical endoscopy · 2025Review
- Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence.Clinics in colon and rectal surgery · 2024Review
- Long-Term Results After Laparoscopic Lavage for Perforated Diverticulitis Purulent Peritonitis in Sweden: A Population-Based Observational Study.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- The Association of Polish Surgeons (APS) clinical guidelines for the use of laparoscopy in the management of abdominal emergencies. Part II.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2023Article
- Functional Outcomes of Emergency Surgery for Perforated Diverticulitis, Hinchey Grade III.World journal of surgery · 2023Observational
- Evidence-based treatment strategies for acute diverticulitis.International journal of colorectal disease · 2021Review
- Laparoscopic Lavage in the Management of Hinchey III/IV Diverticulitis.Clinics in colon and rectal surgery · 2021Review
- Management of perforated diverticulitis with generalized peritonitis. A multidisciplinary review and position paper.Techniques in coloproctology · 2021Review
- Drains, Germs, or Steel: Multidisciplinary Management of Acute Colonic Diverticulitis.Digestive diseases and sciences · 2020Review
- Potential Value of Haptic Feedback in Minimally Invasive Surgery for Deep Endometriosis.Surgical innovation · 2020Article
- Long-term follow-up of a multicentre cohort study on laparoscopic peritoneal lavage for perforated diverticulitis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2019Article
- The Multidisciplinary Management of Acute Complicated Diverticulitis.Inflammatory intestinal diseases · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic peritoneal lavage is an alternative to sigmoid resection in selected patients presenting with purulent peritonitis from perforated diverticulitis. Although recent trials have lacked superiority for lavage in terms of morbidity, mortality was not compromised, and beneficial secondary outcomes were shown. These included shorter duration of surgery, less stoma formation and less surgical reintervention (including stoma reversal) for laparoscopic lavage versus sigmoid resection respectively. The cost analysis of laparoscopic lavage for perforated diverticulitis in the Ladies RCT was assessed in the present study.
methodsThis study involved an economic evaluation of the randomized LOLA (LaparOscopic LAvage) arm of the Ladies trial (comparing laparoscopic lavage with sigmoid resection in patients with purulent peritonitis due to perforated diverticulitis). The actual resource use per individual patient was documented prospectively and analysed (according to intention-to-treat) for up to 1 year after randomization.
resultsEighty-eight patients were randomized to either laparoscopic lavage (46) or sigmoid resection (42). The total medical costs for lavage were lower (mean difference € - 3512, 95 per cent bias-corrected and accelerated c.i. -16 020 to 8149). Surgical reintervention increased costs in the lavage group, whereas stoma reversal increased costs in the sigmoid resection group. Differences in favour of laparoscopy were robust when costs were varied by ±20 per cent in a sensitivity analysis (mean cost difference € - 2509 to -4438).
conclusionLaparoscopic lavage for perforated diverticulitis is more cost-effective than sigmoid resection.
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