Evidence map›Paper›PMID 31713714›Full record

Observational studyInternational journal of colorectal disease2019

Laparoscopic peritoneal lavage versus laparoscopic sigmoidectomy in complicated acute diverticulitis: a multicenter prospective observational study.

Dario Tartaglia, Salomone Di Saverio, Weronika Stupalkowska, Sandro Giannessi, Virna Robustelli, Federico Coccolini, Orestis Ioannidis, Gabriela Elisa Nita, Virginia María Durán Muñoz-Cruzado, Felipe Pareja Ciuró and 1 more

Abstract readComparative StudyMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in International journal of colorectal disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.3field-weighted citation impact, top 19% 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

6 citing papers in PubMed, 19 citations in OpenAlex.

  1. Trial
  2. Observational
  3. Review
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 4 countries.

Dario TartagliaEmergency Surgery Unit, University of Pisa, New Santa Chiara Hospital, Via Paradisa 2, 56124, Pisa, Italy. dario.tartaglia@unipi.it.ORCID http://orcid.org/0000-0003-1615-3370
Salomone Di SaverioCambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK.
Weronika StupalkowskaCambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK.
Sandro GiannessiGeneral Surgery Unit, S. Jacopo Hospital, Pistoia, Italy.
Virna RobustelliGeneral Surgery Unit, S. Jacopo Hospital, Pistoia, Italy.
Federico CoccoliniGeneral and Emergency Surgery Department, ASST Papa Giovanni XXIII, Bergamo, Italy.
Orestis IoannidisFourth Surgical Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Gabriela Elisa NitaGeneral and Emergency Surgery Department, IRCCS, Reggio Emilia, Italy.
Virginia María Durán Muñoz-CruzadoGeneral Surgery Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain.
Felipe Pareja CiuróGeneral Surgery Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain.
Massimo ChiarugiEmergency Surgery Unit, University of Pisa, New Santa Chiara Hospital, Via Paradisa 2, 56124, Pisa, Italy.
Cambridge University Hospitals NHS Foundation Trust · GBHospital Universitario Virgen del Rocío · ESOspedale del Ceppo · ITUniversity of Pisa · ITAristotle University of Thessaloniki · GRAzienda Sanitaria Unità Locale di Reggio Emilia · ITOspedale Papa Giovanni XXIII · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLaparoscopic peritoneal lavage (LPL) is feasible in selected patients with pelvic abscess and generalized purulent peritonitis caused by acute diverticulitis. We aimed to compare LPL and laparoscopic sigmoidectomy (LS) in complicated acute diverticulitis.

methodsThis prospective, observational, multicenter study included patients with a pelvic abscess not amenable to conservative management and patients with Hinchey III acute diverticulitis, from 2015 to 2018. Sixty-six patients were enrolled: 28 (42%) underwent LPL and 38 (58%) underwent LS. In LS, patients had a primary anastomosis, with or without ileostomy, or an end colostomy (HA). Major outcomes were mortality, morbidity, failure of source control, reoperation, length of stay, and diverticulitis recurrence.

resultsPatient demographics were similar in the two groups. In LPL, ASA score > 2 and Mannheim Peritonitis Index were significantly higher (p = 0.05 and 0.004). In LS, 24 patients (63%) had a PA and 14 (37%) an HA. No death was recorded. Overall, morbidity was 33% in LPL and 18% in LS (p = 0.169). However, failure to achieve source control of the peritoneal infection and the need to return to the operating room were more frequent in LPL (p = 0.002 and p = 0.006). Mean postoperative length of stay was comparable (p = 0.08). Diverticular recurrence was significantly higher in LPL (p = 0.003).

conclusionLPL is related to a higher reoperation rate, more frequent postoperative ongoing sepsis, and higher recurrence rates. Therefore, laparoscopic lavage for perforated diverticulitis carries a high risk of failure in daily practice.

Indexed as

LaparoscopyAbdominal AbscessAgedColectomyDiverticulitis, ColonicEuropeFemaleHumansLength of StayMaleMiddle AgedPeritoneal LavagePeritonitisPostoperative ComplicationsProspective StudiesRecurrenceComplicated acute diverticulitisHartmann’s procedureLaparoscopic lavageLaparoscopic sigmoidectomyResection–anastomosis

Identifiers

PMID31713714
OpenAlexW2988476569

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.