Asunto(s)
Antibacterianos/uso terapéutico , Tratamiento Conservador , Diverticulitis , Guías como Asunto , Piperacilina/uso terapéutico , Tazobactam/uso terapéutico , Tomografía Computarizada por Rayos X , Dolor Abdominal/etiología , Administración Intravenosa , Diverticulitis/diagnóstico por imagen , Diverticulitis/tratamiento farmacológico , Femenino , Humanos , Persona de Mediana Edad , Náusea/etiologíaRESUMEN
Importance: Perforated colonic diverticulitis usually requires surgical resection, with significant morbidity. Short-term results from randomized clinical trials have indicated that laparoscopic lavage is a feasible alternative to resection. However, it appears that no long-term results are available. Objective: To compare long-term (5-year) outcomes of laparoscopic peritoneal lavage and primary resection as treatments of perforated purulent diverticulitis. Design, Setting, and Participants: This international multicenter randomized clinical trial was conducted in 21 hospitals in Sweden and Norway, which enrolled patients between February 2010 and June 2014. Long-term follow-up was conducted between March 2018 and November 2019. Patients with symptoms of left-sided acute perforated diverticulitis, indicating urgent surgical need and computed tomography-verified free air, were eligible. Those available for trial intervention (Hinchey stages Asunto(s)
Colectomía/métodos
, Diverticulitis del Colon/terapia
, Perforación Intestinal/terapia
, Laparoscopía/métodos
, Lavado Peritoneal/métodos
, Anciano
, Diverticulitis del Colon/complicaciones
, Femenino
, Humanos
, Perforación Intestinal/etiología
, Masculino
, Noruega
, Suecia