title: Laparoscopic Lavage Is Feasible and Safe for the Treatment of Perforated Diverticulitis With Purulent Peritonitis: The First Results From the Randomized Controlled Trial DILALA.
abstract: OBJECTIVE
  To evaluate short-term outcomes of a new treatment for perforated diverticulitis with purulent peritonitis in a randomized controlled trial.
  
  
  BACKGROUND
  Perforated diverticulitis with purulent peritonitis (Hinchey III) has traditionally been treated with surgery including colon resection and stoma (Hartmann procedure) with considerable postoperative morbidity and mortality. Laparoscopic lavage has been suggested as a less invasive surgical treatment.
  
  
  METHODS
  Laparoscopic lavage was compared with colon resection and stoma in a randomized controlled multicenter trial, DILALA (ISRCTN82208287). Initial diagnostic laparoscopy showing Hinchey III was followed by randomization. Clinical data was collected up to 12 weeks postoperatively.
  
  
  RESULTS
  Eighty-three patients were randomized, out of whom 39 patients in laparoscopic lavage and 36 patients in the Hartmann procedure groups were available for analysis. Morbidity and mortality after laparoscopic lavage did not differ when compared with the Hartmann procedure. Laparoscopic lavage resulted in shorter operating time, shorter time in the recovery unit, and shorter hospital stay.
  
  
  CONCLUSIONS
  In this trial, laparoscopic lavage as treatment for patients with perforated diverticulitis Hinchey III was feasible and safe in the short-term.
authors.affiliation: *Department of Surgery, Institute of Clinical Sciences, Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden †Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej, Herlev, Denmark ‡Department of Surgery, Skaraborgs Hospital, Skovde, Sweden §GastroUnit, Surgical Division, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark ¶Department of Surgery, Roskilde Hospital, Denmark ||NÄL Hospital Group, Trollhättan, Sweden **Department of Surgery, Örebro University Hospital, Örebro, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Angenete
authors.forename: Anders
authors.initials: A
authors.lastname: Thornell
authors.forename: Jakob
authors.initials: J
authors.lastname: Burcharth
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Pommergaard
authors.forename: Stefan
authors.initials: S
authors.lastname: Skullman
authors.forename: Thue
authors.initials: T
authors.lastname: Bisgaard
authors.forename: Per
authors.initials: P
authors.lastname: Jess
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Läckberg
authors.forename: Peter
authors.initials: P
authors.lastname: Matthiessen
authors.forename: Jane
authors.initials: J
authors.lastname: Heath
authors.forename: Jacob
authors.initials: J
authors.lastname: Rosenberg
authors.forename: Eva
authors.initials: E
authors.lastname: Haglind
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000150:complications / Q000628:therapy*; D004238:Diverticulitis / Q000150:complications / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications / Q000628:therapy*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications / Q000628:therapy*; D011446:Prospective Studies; D013492:Suppuration / Q000150:complications / Q000628:therapy; D007507:Therapeutic Irrigation / Q000379:methods*; D055815:Young Adult