Laparoscopic lavage/drainage as a bridge treatment for perforated diverticulitis with purulent peritoni-tis associated with an abdominal aortic aneurysm. A retrospective case-control study


COD: 03_2019_12_2913 Categorie: ,

Giulio Illuminati, Dimitri Krizzuk, Francesco G.Calio, Paolo Urciuoli, Giulia Pizzardi, Rocco Pasqua

Ann. Ital. Chir., 2019 90, 3: 258-263

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AIM: Laparoscopic lavage /drainage (LALA) or surgical resection are both methods of treatment for perforated divertic-ulitis with purulent peritonitis (Hinchey Stage III). In case of associated abdominal aortic aneurysm (AAA), laparoscopiclavage/drainage could be an interesting bridge option to treat sepsis before endovascular exclusion of the aneurysm andresection of the sigmoid. We performed LALA as a bridge treatment of peritonitis before elective, staged endovascularexclusion of the aneurysm (EE) and elective resection of the colon.MATERIAL ANDMETHODS: Seven patients presenting a perforated diverticulitis with purulent peritonitis (Hinchey III),associated with an uncomplicated AAA of a mean diameter of 6 cm, underwent LALA followed by staged EE and resec-tion. They were retrospectively reviewed for a case-control study. The mean length of follow-up after completing all the pro-cedures was 28 months. Primary endpoints were mortality and morbidity of each procedure, complications related to eachprocedure and to the untreated disease in the interval between each one of them, late outcome and complications relatedto each treatment method. As secondary endpoints, the mean length of surgery for resection, of stay in the hospital, of theinterval between each procedure, and of time required for the treatment of both the diseases were considered.