- In patients with purulent perforated acute diverticulitis, laparoscopic lavage (LL) vs colonic resection (CR) provides similar mortality, shorter operative time and hospital stay.
- However, evidence suggests that LL might be inadequate for sepsis control and result in more unplanned reoperations.
Why this matters
- Findings do not support that LV is superior to a traditional CR and may not be recommended as a safer alternative in the management of purulent perforated acute diverticulitis
- Systematic review and meta-analysis of 11 studies including a total of 569 patients with diverticulitis (HincheyⅢ >80%).
- Funding: None.
- Overall, 276 patients received LL and 283 underwent CR.
- The LL vs CR group was associated with significantly shorter:
- operative time (weighted mean difference [WMD]; −78.85; 95% CI, -100.58 to -57.11; P<.0001 and>
- length of hospital stays (WMD, −7.62; 95% CI, -11.60 to -3.63; P=.0002).
- Heterogeneity among included studies.
- Lack of individual patient data.