Assuntos
Antibacterianos/uso terapêutico , Tratamento Conservador , Diverticulite , Guias como Assunto , Piperacilina/uso terapêutico , Tazobactam/uso terapêutico , Tomografia Computadorizada por Raios X , Dor Abdominal/etiologia , Administração Intravenosa , Diverticulite/diagnóstico por imagem , Diverticulite/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Náusea/etiologiaRESUMO
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 Assuntos
Colectomia/métodos
, Doença Diverticular do Colo/terapia
, Perfuração Intestinal/terapia
, Laparoscopia/métodos
, Lavagem Peritoneal/métodos
, Idoso
, Doença Diverticular do Colo/complicações
, Feminino
, Humanos
, Perfuração Intestinal/etiologia
, Masculino
, Noruega
, Suécia