Evidence map›Paper›PMID 29663316›Full record

Trial reportThe British journal of surgery2018

Two-year results of the randomized clinical trial DILALA comparing laparoscopic lavage with resection as treatment for perforated diverticulitis.

A Kohl, J Rosenberg, D Bock, T Bisgaard, S Skullman, A Thornell, J Gehrman, E Angenete, E Haglind

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The British journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 6 pooled it
12.5field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 6 syntheses or guidelines pooled it, 101 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
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  6. Pooled it
  7. Trial
  8. Article
  9. Article
  10. Article
  11. Surgery for diverticular peritonitis.Frontiers in medicine · 2025
    Review
  12. Review
  13. 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 · 2024
    Article
  14. Observational
  15. Diverticulitis, surgery, evidence-based medicine, and the Steve Jobs' dots: a narrative review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
    Review
  16. Article
  17. Review
  18. Review
  19. Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

A KohlCentre for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev, and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
J RosenbergCentre for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev, and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
D BockDepartment of Surgery, Institute of Clinical Sciences, Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
T BisgaardGastroUnit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
S SkullmanDepartment of Surgery, Skövde Hospital, Skövde, Sweden.
A ThornellDepartment of Surgery, Institute of Clinical Sciences, Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
J GehrmanDepartment of Surgery, Institute of Clinical Sciences, Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
E AngeneteDepartment of Surgery, Institute of Clinical Sciences, Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
E HaglindDepartment of Surgery, Institute of Clinical Sciences, Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.ORCID 0000-0002-1147-5605
Sahlgrenska University Hospital · SEUniversity of Copenhagen · DKSkaraborg Hospital · SE

Funding

Adlerbertska Research FoundationAlice Swenzons FoundationAnna-Lisa and Bror Björnsson FoundationBengt Ihre FoundationFaith Regen FoundationGöteborg Medical SocietyHealth and Medical Care Committee of the Regional Executive Board and Region Västra GötalandJohan & Jacob Söderberg FoundationMagnus Bergvall FoundationMary von Sydow FoundationRuth and Richard Julin FoundationSahlgrenska University HospitalSahlgrenska University Hospital Health Technology Assessment CenterSigne and Olof Wallenius FoundationSwedish Research Council 2012-1770Swedish Research Council 2015-02483Swedish Society of MedicineWilhelm & Martina Lundgren Foundation
6 · The paper itself

Abstract

backgroundTraditionally, perforated diverticulitis with purulent peritonitis was treated with resection and colostomy (Hartmann's procedure), with inherent complications and risk of a permanent stoma. The DILALA (DIverticulitis - LAparoscopic LAvage versus resection (Hartmann's procedure) for acute diverticulitis with peritonitis) and other randomized trials found laparoscopic lavage to be a feasible and safe alternative. The medium-term follow-up results of DILALA are reported here.

methodsPatients were randomized during surgery after being diagnosed with Hinchey grade III perforated diverticulitis at diagnostic laparoscopy. The primary outcome was the proportion of patients with one or more secondary operations from 0 to 24 months after the index procedure in the laparoscopic lavage versus Hartmann's procedure groups. The trial was registered as ISRCTN82208287.

resultsForty-three patients were randomized to laparoscopic lavage and 40 to Hartmann's procedure. Patients in the lavage group had a 45 per cent reduced risk of undergoing one or more operations within 24 months (relative risk 0·55, 95 per cent c.i. 0·36 to 0·84; P = 0·012) and had fewer operations (ratio 0·51, 95 per cent c.i. 0·31 to 0·87; P = 0·024) compared with those in the Hartmann's group. No difference was found in mean number of readmissions (1·37 versus 1·50; P = 0·221) or mortality between patients randomized to laparoscopic lavage or Hartmann's procedure. Three patients in the lavage group and nine in the Hartmann's group had a colostomy at 24 months.

conclusionLaparoscopic lavage is a better option for perforated diverticulitis with purulent peritonitis than open resection and colostomy.

Indexed as

AdultAgedColonDiverticulitis, ColonicFeasibility StudiesFemaleFollow-Up StudiesHumansIntestinal PerforationLaparoscopyLength of StayMaleMiddle AgedPeritoneal LavagePeritonitisProspective Studies

Identifiers

PMID29663316
PMCPMC6055876
OpenAlexW2801892059

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.