title: [Value of one-stage surgical treatment of diffuse peritonitis (relaparotomy on demand): a single-center analysis].
abstract: BACKGROUND
  Despite modern surgical and intensive-care concepts, diffuse peritonitis remains a major source of high morbidity and mortality. The aim of this study was to critically evaluate the value of relaparotomy on demand (ROD) for patients with diffuse peritonitis.
  
  
  RESULTS
  In a retrospective analysis, the clinical course of 231 patients with diffuse peritonitis was analysed. The mean Mannheim Peritonitis Index (MPI) was 25.3. Overall lethality in this cohort was 14.3 %. In 214 patients, source control was successful during the index operation, and these patients were treated according to an on-demand strategy. For 178 of these patients, there was no demand for a relaparotomy, whereas 36 of these patients required further surgical interventions. Lethality for these subgroups was 9 % (no relaparotomy) and 27 % (relaparotomy), respectively.
  
  
  CONCLUSIONS
  This retrospective analysis confirms that an on-demand strategy is reasonable and feasible after successful source control and lavage. However, it still remains of clinical importance to identify parameters that may assist in selecting those patients who require a relaparotomy.
authors.affiliation: Centrum für Muskuloskeletale Chirurgie, Charité Universitätsmedizin Berlin, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Pauly
authors.forename: F P
authors.initials: FP
authors.lastname: Schulze
authors.forename: O
authors.initials: O
authors.lastname: Horstmann
authors.forename: H
authors.initials: H
authors.lastname: Becker
authors.forename: M
authors.initials: M
authors.lastname: Grade
authors.forename: M
authors.initials: M
authors.lastname: Ghadimi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D061887:Conversion to Open Surgery; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000401:mortality / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D010538:Peritonitis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D012086:Reoperation / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality / Q000601:surgery; D013529:Surgical Wound Dehiscence / Q000401:mortality / Q000601:surgery; D015996:Survival Rate