Is it safe and useful, laparoscopic peritoneal lavage in the treatment of acute diverticulitis of octogenarian patients? A multicenter retroprospective observational study.
BACKGROUND
Diverticular disease of the colon also affects older people. Generally, older patients with diverticulitis may be regarded as too risky to undergo surgery. This retroprospective multicentric observational study aims to assess the safety and benefits of laparoscopic peritoneal lavage (LPL) in elderly patients with perforated sigmoid diverticulitis.


METHODS
We hospitalized in urgency 100 patients, aged over 75, for sigmoid diverticulitis. Sixty-nine patients were treated with conservative medical therapy, while 31 were treated surgically, in which the surgery was performed in urgency in 18 cases, while in election in 13 cases. Laparoscopic peritoneal lavage was made in urgency in five cases.


RESULTS
The mean age of the sample was 81.72. Thirty-one patients underwent surgery, and five patients were treated in urgency with laparoscopic peritoneal lavage. Perioperative mortality was zero. None of the patients who underwent laparoscopic peritoneal lavage showed recurrent disease.


CONCLUSIONS
Diagnostic laparoscopy can be useful in elderly patient, since these patients may benefit from a more conservative surgical strategy. The selection of patients to be subjected to laparoscopic lavage must be very rigorous.
Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte, 1, 06134, Perugia, Italy.
Carlo
C
Boselli
Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte, 1, 06134, Perugia, Italy.
Alessandro
A
Gemini
Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte, 1, 06134, Perugia, Italy.
Roberto
R
Cirocchi
Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte, 1, 06134, Perugia, Italy.
Veronica
V
Grassi
Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio, 1, 05100, Terni, Italy.
Stefano
S
Avenia
Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio, 1, 05100, Terni, Italy.
Andrea
A
Polistena
Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio, 1, 05100, Terni, Italy.
Alessandro
A
Sanguinetti
Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena, 32400161, Rome, Italy.
Daniele
D
Pironi
Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena, 32400161, Rome, Italy.
Alberto
A
Santoro
Department of Gastrointestinal and General Surgery, Medical University of Wrocław, Wrocław, Poland.
Renata
R
Tabola
Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte, 1, 06134, Perugia, Italy.
Maria Federica
MF
Burattini
Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio, 1, 05100, Terni, Italy.
Nicola
N
Avenia
D000368:Aged; D000369:Aged, 80 and over; D000072700:Conservative Treatment / Q000379:methods / Q000706:statistics & numerical data; D004238:Diverticulitis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D018579:Patient Selection; D010533:Peritoneal Lavage / Q000379:methods*; D020379:Risk Adjustment; D016896:Treatment Outcome
Diverticulitis; Elderly patients; Laparoscopic peritoneal lavage; Urgency