Trial reportInternational journal of colorectal disease2021
Long-term outcomes of Hartmann's procedure versus primary anastomosis for generalized peritonitis due to perforated diverticulitis: follow-up of a prospective multicenter randomized trial (DIVERTI).
Trial report in International journal of colorectal disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
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.
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, 3 syntheses or guidelines pooled it, 30 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
- EAES rapid guideline: surgical management of complicated diverticulitis - with ESCP participation.Surgical endoscopy · 2025Guideline
- 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
- Robotic Hartmann reversal is associated with reduced postoperative complications compared with laparoscopic approach: a propensity-weighted NSQIP study.Surgical endoscopy · 2026Article
- Surgeon perspective on the treatment of acute diverticulitis: A survey-based analysis.Surgery · 2026Article
- Clinical outcomes after surgery for benign stomach versus colorectal perforations.BMC surgery · 2025Article
- Hartmann's procedure versus primary anastomosis for Hinchey III or IV sigmoid diverticulitis: a propensity score analysis of a retrospective national cohort study.Surgical endoscopy · 2025Article
- 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
- Stoma reversal after emergency stoma formation-the importance of timing: a multi-centre retrospective cohort study.World journal of emergency surgery : WJES · 2025Article
- Variation in the surgical management of complicated diverticulitis: a cross-sectional study of European surgeons.Surgical endoscopy · 2025Article
- Contemporary management of diverticulitis.Surgery open science · 2024Article
- 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 · 2024Review
- Diverticulitis is a population health problem: Lessons and gaps in strategies to implement and improve contemporary care.World journal of gastrointestinal surgery · 2023Review
- Anastomotic Considerations in Diverticulitis.Clinics in colon and rectal surgery · 2023Review
- Current Aspects on the Management of Perforated Acute Diverticulitis: A Narrative Review.Cureus · 2022Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical management of Hinchey III and IV diverticulitis involves Hartmann's procedure (HP) or primary resection anastomosis (PRA) with or without fecal diversion. These procedures were evaluated in four randomized controlled trials. Early results from these trials demonstrated similar rates of complications but higher rates of colonic restoration after PRA than HP. Long-term follow-up has not been reported to date. The aim of this study was to analyze long-term outcomes and quality of life (QoL) in patients previously enrolled in a prospective randomized trial comparing HP and PRA for generalized peritonitis due to perforated diverticulitis (DIVERTI trial). STUDY
designFollow-up data were available for 78 of 102 patients. Demographic data, incisional hernia rate, need for additional surgery related to the primary procedure, and QoL were recorded.
resultsThe overall survival rate was 76% and did not differ between the two groups. Incisional hernia was reported in 21 (52%) patients in the HP arm and in 11 (29%) patients in the PRA arm (p = 0.035). The HP arm demonstrated significantly lower SF-36 physical and mental component scores. The mean general QoL (EQ-VAS) and mean EQ-5D index scores were better after PRA than after HP, but this difference was not statistically significant. The results of GIQLI, which measures intestine-specific QOL, did not differ between the two groups.
conclusionsThis follow-up study with a median follow-up time of > 9 years among living patients indicates that PRA for perforated diverticulitis is associated with fewer long-term complications and better QoL than HP. PRA significantly reduced the incisional hernia rate and the need for reoperation. Long-term survival was not jeopardized by the PRA approach. Future studies are needed to address the utility of protective stoma.
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