A historical review of surgery for peritonitis secondary to acute colonic diverticulitis: from Lockhart-Mummery to evidence-based medicine

Roberto Cirocchi; Sorena Afshar; Salomone Di Saverio; Georgi Popivanov; Angelo De Sol; Francesca Gubbiotti; Gregorio Tugnoli; Massimo Sartelli; Fausto Catena; David Cavaliere; Renata Taboła; Abe Fingerhut; Gian Andrea Binda

doi:10.1186/s13017-017-0120-y

World Journal of Emergency Surgery

Table 10 Meta-analysis about laparoscopic abdominal lavage

From: A historical review of surgery for peritonitis secondary to acute colonic diverticulitis: from Lockhart-Mummery to evidence-based medicine

	Cirocchi		Ceresoli	Angenete	Marshall
	All Hinchey	Hinchey III	Hinchey III	Hinchey III	Hinchey III
Post-operative mortality at index admission or within 30 days from index intervention	RR 1.33, 95% CI 0.37 to 4.74	RR 3.01, 95% CI 0.48 to 18.93	OR 0.93; 95% C.I. 0.23–3.82; P = 0.92	RR 1.34, 95% CI 0.59–3.04	RR 1.34, 95% CI 0.37 to 4.79
Mortality at 90 days	RR 1.27, 95% CI 0.60 to 2.69	Not performed^j	OR 0.83; 95% C.I. 0.32–2.11; P = 0.69	RR 0.86, 95% CI 0.40–1.83	RR 0.86, 95% CI 0.40 to 1.84
Mortality at 12 months	RR 0.84, 95% CI 0.38 to 1.88	Not performed^j	OR 0.74 P = 0.51	RR 0.54, 95% CI 0.38–0.76
Reoperation at index admission or within 30 days from index intervention	RR 1.93, 95% CI 0.71 to 5.22	RR = 1.40, 95% CI 0.71 to 4.90	OR 3.75, P = 0.006	RR 1.34, 95% CI 0.59–3.04	RR 3.03, 95% CI 1.16 to 7.89
At 90 days follow reoperations	Not analyzed^a	Not performed^j	NR	RR 1.71, 95% CI 0.85–3.43	NR
At 12 months follow reoperations	RR 0.57, 95% CI 0.39 to 0.86	Not performed^j	OR 0.32, P = 0.0004	RR 0.54, 95% CI 0.38–0.76	NR
Intra-abdominal abscesses at index admission or within 30 days from index intervention	Not analyzed^b	Not performed^j	OR 3.50; 95% C.I. 1.79–6.86; P = 0.0003	NR	NR
Intra-abdominal abscesses at 90 days	RR = 2.54, 95% CI 1.34 to 4.83	Not performed^j	NR	NR	NR
Wound infections	RR = 0.10, 95% CI 0.02 to 0.51	Not performed^j	OR 0.14; 95% C.I. 0.04–0.45; P = 0.0009	NR	NR
Morbidity at 90 days	Not performed^j	Not performed^j	OR 1.70; 95% C.I. 1.00–2.87; P = 0.05	NR	NR
Presence of stoma at 12 months	RR = 0.50, 95% CI 0.14 to 1.75	Not performed^j	OR 0.44 P = 0.27	NR	RR 0.50, 95% CI 0.14 to 1.76
Operating time	Not analyzed^c	Not performed^j	NR	NR	NR
Post-operative persistent peritonitis	Not analyzed^d	Not performed^j	NR	NR	NR
Post-operative secondary peritonitis	Not analyzed^e	Not performed^j	NR	NR	NR
Length of post-operative hospital stay during index admission.	WMD −2.03, 95% CI−2.59 to−1.47	Not performed^j	NR	NR	NR
Adverse events within 90 days by Dindo-Clavien grade I-II	Not analyzed^f	Not performed^j	NR	NR	NR
Adverse events within 90 days by Dindo-Clavien grade IIIa	Not analyzed^g	Not performed^j	NR	NR	NR
Adverse events within 90 days by Dindo-Clavien grade IIIb	RR 1.40, 95% CI 0.47 to 4.17	Not performed^j	NR	RR 1.46, 95% CI 0.99–2.20	NR
Adverse events within 90 days by Dindo-Clavien grade IVa	RR 0.59, 95% CI 0.20 to 1.75	Not performed^j	NR	NR	NR
Adverse events within 90 days by Dindo-Clavien grade IVb	RR 0.62, 95% CI 0.10 to 3.75	Not performed^j	NR	NR	NR
Total length of hospital stays within 12 months.	Not analyzed^h	Not performed^j	NR	NR	NR
Quality of Life	Not analyzedⁱ	Not performed^j	NR	NR	NR
Post-operative ICU admission	NR	NR	NR	NR	RR 0.85, 95% CI 0.40 to 1.78

NR not reported
^aTwo trials (LADIES and DILALA) reported this outcome, but the LADIES reported only the abscesses needing percutaneous drainage, differently the DILALA reported only the abscess underwent surgical reintervention
^bOnly one trial (SCANDIV) reported this outcome
^cThis outcome was reported in the SCANDIV although a definition of operating time was not provided. In the DILALA trial, the duration of surgery, and time between end of surgery and the end of anesthesia was reported. In the LADIES trial, the results of a comparative analysis were provided in the absence of the primary data. Because of the incongruous reports of operating time, for these reasons the analysis of this outcome was not performed
^dOnly the DILALA trial analyzed this outcome as persistent peritonitis
^eOnly the SCANDIV trial analyzed this outcome of persistent peritonitis
^fOnly the DILALA trial reported this outcome
^gOnly the DILALA trial reported this outcome
^hOnly the DILALA trial reported this outcome
ⁱAll the included trials reported this outcome; however, the data of quality of life questionnaires were not comparable
^jLack of data

Back to article page

ISSN: 1749-7922

Contact us

Submission enquiries: Access here and click Contact Us
General enquiries: info@biomedcentral.com