[Laparoscopic lavage and drainage in the surgical treatment of diverticular disease complicated by peritonitis].
The treatment of peritonitis complicating diverticular disease of the colon is yet to be universally regarded as established practice and major differences in management are to be noted in the various surgical institutions. In the emergency setting, the minimally invasive approach is used by few surgeons and the most frequent therapeutic options are sigmoid resection with primary anastomosis (with or without a diverting stoma) and Hartmann's procedure. The Authors report their preliminary experience (13 cases) with laparoscopic lavage and drainage without colonic resection in diverticulitis complicated by peritonitis and describe the technical details of the surgical procedure. They conduct a systematic review of the literature and, on the basis of their latest experience, compare the results of the traditional resective operations (resection with primary anastomosis and Hartmann's procedure) with those of laparoscopic conservative and non-resective treatment. Laparoscopic non-resective procedures reduce the frequency and severity of the surgical complications, as well as the hospital stay and costs of treatment. In conclusion, laparoscopic lavage and drainage can be used in the majority of patients, with excellent prospects of recovery, without disabling stomas, in a single operative stage.
Lippi
Carlo Ettore
CE
S.C. di Chirurgia Generale, Ospedale San Bartolomeo, A.S.L. n. 5 Spezzino, Sarzana (La Spezia).
Beatini
Luca
L
Cervia
Silvio
S
Fabbricotti
Alaido
A
Miaruelli
Piero Antonio
PA
Spessa
Elisabetta
E
Sturlese
Ivarco
I
Braini
Andrea
A
D000368:Aged; D000369:Aged, 80 and over; D043963:Diverticulosis, Colonic / Q000150:complications* / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D010538:Peritonitis / Q000209:etiology*; D007507:Therapeutic Irrigation / Q000379:methods*