title: Laparoscopic peritoneal lavage: our experience and review of the literature.
abstract: BACKGROUND
  Over the years various therapeutic techniques for diverticulitis have been developed. Laparoscopic peritoneal lavage (LPL) appears to be a safe and useful treatment, and it could be an effective alternative to colonic resection in emergency surgery.
  
  
  OBJECTIVE
  This prospective observational study aims to assess the safety and benefits of laparoscopic peritoneal lavage in perforated sigmoid diverticulitis.
  
  
  METHODS
  We surgically treated 70 patients urgently for complicated sigmoid diverticulitis. Thirty-two (45.7%) patients underwent resection of the sigmoid colon and creation of a colostomy (Hartmann technique); 21 (30%) patients underwent peritoneal laparoscopic lavage; 4 (5.7%) patients underwent colostomy by the Mikulicz technique; and the remaining 13 (18.6%) patients underwent resection of the sigmoid colon and creation of a colorectal anastomosis with a protective ileostomy.
  
  
  RESULTS
  The 66 patients examined were divided into 3 groups: 32 patients were treated with urgent surgery according to the Hartmann procedure; 13 patients were treated with resection and colorectal anastomosis; 21 patients were treated urgently with laparoscopic peritoneal lavage. We had no intraoperative complications. The overall mortality was 4.3% (3 patients). In the LPL group the morbidity rate was 33.3%.
  
  
  CONCLUSIONS
  Currently it cannot be said that LPL is better in terms of mortality and morbidity than colonic resection. These data may, however, be proven wrong by greater attention in the selection of patients to undergo laparoscopic peritoneal lavage.
authors.affiliation: Department of Digestive Surgery, St. Mary's Hospital, University of Perugia, Terni, Italy.
authors.forename: Amilcare
authors.initials: A
authors.lastname: Parisi
authors.affiliation: Department of Digestive Surgery, St. Mary's Hospital, University of Perugia, Terni, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gemini
authors.affiliation: Department of Digestive Surgery, St. Mary's Hospital, University of Perugia, Terni, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Desiderio
authors.affiliation: Department of General Surgery, St. Maria della Misericordia's Hospital, University of Perugia, Perugia, Italy.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Petrina
authors.affiliation: Department of Digestive Surgery, St. Mary's Hospital, University of Perugia, Terni, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Trastulli
authors.affiliation: Department of Digestive Surgery, St. Mary's Hospital, University of Perugia, Terni, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Grassi
authors.affiliation: Department of Digestive Surgery, St. Mary's Hospital, University of Perugia, Terni, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Sani
authors.affiliation: Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Pironi
authors.affiliation: Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Santoro
keywords: Hartmann's procedure; colon resection; diverticular disease; laparoscopic peritoneal lavage; urgency