SynthesisInternational journal of colorectal disease2020
Sigmoid resection with primary anastomosis versus the Hartmann's procedure for perforated diverticulitis with purulent or fecal peritonitis: a systematic review and meta-analysis.
Synthesis in International journal of colorectal disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Surgical management of complicated diverticulitis: systematic review and individual patient data network meta-analysis : An EAES/ESCP collaborative project.Surgical endoscopy · 2025Pooled it
- The influence of preoperative e intraoperative factors in predicting postoperative morbidity and mortality in perforated diverticulitis: a systematic review and meta-analysis.Updates in surgery · 2024Pooled it
- Damage control surgery and open abdomen in Hinchey III-IV acute diverticulitis: current practice from a nationwide Italian survey.Updates in surgery · 2026Article
- An unexpected uro-digestive connection: pyelosigmoid fistula in an ectopic pelvic kidney.Journal of surgical case reports · 2026Article
- Outcomes of damage control surgery in perforated sigmoid diverticulitis: a comparison before and after implementing a new treatment algorithm.Updates in surgery · 2026Article
- Hartmann's procedure reversal rate and short-term outcomes: a single centre retrospective cohort study.BMC surgery · 2026Article
- Surgeon perspective on the treatment of acute diverticulitis: A survey-based analysis.Surgery · 2026Article
- Minimally invasive emergency colorectal surgery in nonspecialist surgical centers: a necessity, not a luxury.Journal of minimally invasive surgery · 2025Article
- Success in Diverticulitis Management: What Outcomes Really Matter?Clinics in colon and rectal surgery · 2025Review
- Acute Left-Side Colonic Diverticulitis: A Historical Cohort Study on the Optimization of Non-Operative Management Outcomes and Anastomosis Rate After Sigmoid Resection.Journal of clinical medicine · 2025Article
- Diverticulitis in Older Adults: A Review of Etiology, Diagnosis, and Management.Journal of the American Geriatrics Society · 2025Review
- Contemporary management of diverticulitis.Surgery open science · 2024Article
- Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago.World journal of emergency surgery : WJES · 2024Observational
- Outcomes of surgical treatment of diverticular abscesses after failure of antibiotic therapy.Updates in surgery · 2023Article
- Current Aspects on the Management of Perforated Acute Diverticulitis: A Narrative Review.Cureus · 2022Review
- Essential updates 2020/2021: Colorectal diseases (benign)-Current topics in the surgical and medical treatment of benign colorectal diseases.Annals of gastroenterological surgery · 2022Review
- Laparoscopic resection and primary anastomosis for perforated diverticulitis: with or without loop ileostomy? The response is the colon leakage risk score!Updates in surgery · 2022Article
- State-of-the-art surgery for sigmoid diverticulitis.Langenbeck's archives of surgery · 2022Article
- Management of perforated diverticulitis with generalized peritonitis. A multidisciplinary review and position paper.Techniques in coloproctology · 2021Review
- Current management of acute left colon diverticulitis: What have Italian surgeons learned after the IPOD study?Updates in surgery · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe optimal surgical approach for perforated diverticulitis with purulent or fecal peritonitis (Hinchey grade III or IV) remains debated. In recent years, accumulating evidence comparing sigmoid resection with primary anastomosis (PA) with the Hartmann's procedure (HP) was presented. Therefore, the aim was to provide an updated and extensive synthesis of the available evidence.
methodsA systematic search in Embase, MEDLINE, Cochrane, and Web of Science databases was performed. Studies comparing PA to HP for adult patients with Hinchey III or IV diverticulitis were included. Data on mortality, morbidity, stoma reversal, and patient-reported and cost-related outcomes were extracted. Random effects models were used to pool data and estimate odds ratios (ORs).
resultsFrom a total of 1560 articles, four randomized controlled trials and ten observational studies were identified, reporting on 1066 Hinchey III/IV patients. Based on trial outcomes, PA was found to be favorable over HP in terms of stoma reversal rates (OR 2.62, 95% CI 1.29, 5.31) and reversal-related morbidity (OR 0.33, 95% CI 0.16, 0.69). No differences in mortality (OR 0.83, 95% CI 0.32, 2.19), morbidity (OR 0.99, 95% CI 0.65, 1.51), and reintervention rates (OR 0.90, 95% CI 0.39, 2.11) after the index procedure were demonstrated. Data on patient-reported and cost-related outcomes were scarce, as well as outcomes in PA patients with or without ileostomy construction and Hinchey IV patients.
conclusionAlthough between-study heterogeneity needs to be taken into account, the present results indicate that primary anastomosis seems to be the preferred option over Hartmann's procedure in selected patients with Hinchey III or IV diverticulitis.
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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.