Format

Send to

Choose Destination
See comment in PubMed Commons below
Int J Colorectal Dis. 2003 Nov;18(6):503-7. Epub 2003 Aug 9.

Primary anastomosis after intraoperative colonic lavage vs. Hartmann's procedure in generalized peritonitis complicating diverticular disease of the colon.

Author information

1
Department of Visceral Surgery, C.H.U. Angers, 4 rue Larrey, 49033, Angers Cedex 01, France. nicoregenet@yahoo.fr

Abstract

BACKGROUND AND AIMS:

For complicated diverticulitis Hartmann's procedure remains the favored option in patients with acute complicated sigmoid disease, but there has been increasing interest in primary resection and anastomosis with intraoperative colonic lavage. This study compared primary resection with intraoperative colonic lavage and Hartmann's procedure.

PATIENTS AND METHODS:

Between January 1994 and November 2001, 60 patients underwent emergency laparotomy for diverticular peritonitis (Hinchey stages III and IV). Primary resection and anastomosis with intraoperative colonic lavage was performed in 27 patients and Hartmann's procedure in 33. All data were collected prospectively on a standardized form.

RESULTS:

Mortality with intraoperative colonic lavage was 11% and with Hartmann's procedure 12%. The incidence of postoperative complication was significantly higher after Hartmann's procedure. The mean hospital stay was significantly longer after Hartmann's procedure than after primary resection with intraoperative colic lavage.

CONCLUSION:

Primary resection with intraoperative colonic lavage compares favorably with Hartmann's procedure for diffuse purulent peritonitis in complicated diverticulitis. It should be an alternative to Hartmann's procedure in stercoral peritonitis.

PMID:
12910361
DOI:
10.1007/s00384-003-0512-1
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Support Center