SynthesisBMC surgery2021
Damage control strategy in perforated diverticulitis with generalized peritonitis.
Synthesis in BMC surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06428370 (An International Study Investigating the Adoption and Outcome of Damage Control Surgery in Hinchey III-IV Acute Diverticulitis), which is not on this map. Cited by 14 papers.
What it found
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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.
An International Study Investigating the Adoption and Outcome of Damage Control Surgery in Hinchey III-IV Acute Diverticulitis (DACOSAD)
Who cites it
14 citing papers in PubMed, 24 citations in OpenAlex.
- Damage control surgery and open abdomen in Hinchey III-IV acute diverticulitis: current practice from a nationwide Italian survey.Updates in surgery · 2026Article
- Practice patterns in the surgical management of Hinchey III and IV diverticulitis: results of a national survey.Surgical endoscopy · 2026Article
- Re: Outcomes of damage control surgery in perforated sigmoid diverticulitis: a comparison before and after implementing a new treatment algorithm.Updates in surgery · 2026Article
- Outcomes of damage control surgery in perforated sigmoid diverticulitis: a comparison before and after implementing a new treatment algorithm.Updates in surgery · 2026Article
- Review
- Role of Damage Control Surgery in Perforated Diverticulitis Management: A Systematic Review.Cureus · 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
- Abdominal compartment syndrome: what radiologist needs to know.La Radiologia medica · 2023Review
- Is damage control surgery useful in the treatment of colorectal perforation? A single-center case-control study.Annals of medicine and surgery (2012) · 2023Article
- Accuracy of computed tomography in staging acute appendicitis and its impact on surgical outcome and strategy: a multi-center retrospective case-control study.La Radiologia medica · 2023Article
- Distant free air is not a contraindication for definitive laparoscopic treatment of acute perforated diverticulitis: a multi-center experience.Updates in surgery · 2022Article
- Current Aspects on the Management of Perforated Acute Diverticulitis: A Narrative Review.Cureus · 2022Review
- Usefulness of damage control approach in patients with limited acute mesenteric ischemia: a prospective study of 85 patients.Updates in surgery · 2022Article
- The results of rapid source control laparotomy or open abdomen for acute diverticulitis.Langenbeck's archives of surgery · 2022Article
Corrections and comments
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Authors and funding
12 authors at 10 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe best treatment for perforated colonic diverticulitis with generalized peritonitis is still under debate. Concurrent strategies are resection with primary anastomosis (PRA) with or without diverting ileostomy (DI), Hartmann's procedure (HP), laparoscopic lavage (LL) and damage control surgery (DCS). This review intends to systematically analyze the current literature on DCS.
methodsDCS consists of two stages. Emergency surgery: limited resection of the diseased colon, oral and aboral closure, lavage, vacuum-assisted abdominal closure. Second look surgery after 24-48 h: definite reconstruction with colorectal anastomosis (-/ + DI) or HP after adequate resuscitation. The review was conducted in accordance to the PRISMA-P Statement. PubMed/MEDLINE, Cochrane central register of controlled trials (CENTRAL) and EMBASE were searched using the following term: (Damage control surgery) AND (Diverticulitis OR Diverticulum OR Peritonitis).
resultsEight retrospective studies including 256 patients met the inclusion criteria. No randomized trial was available. 67% of the included patients had purulent, 30% feculent peritonitis. In 3% Hinchey stage II diverticulitis was found. In 49% the Mannheim peritonitis index (MPI) was greater than 26. Colorectal anastomosis was constructed during the course of the second surgery in 73%. In 15% of the latter DI was applied. The remaining 27% received HP. Postoperative mortality was 9%, morbidity 31% respectively. The anastomotic leak rate was 13%. 55% of patients were discharged without a stoma.
conclusionDCS is a safe technique for the treatment of acute perforated diverticulitis with generalized peritonitis, allowing a high rate of colorectal anastomosis and stoma-free hospital discharge in more than half of the patients.
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