Journal article

Operative strategies for diverticular peritonitis - A decision analysis between primary resection and anastomosis versus Hartmann's procedures

Vasilis A Constantinides, Alexander Heriot, Feza Remzi, Ara Darzi, Asha Senapati, Victor W Fazio, Paris P Tekkis

ANNALS OF SURGERY | LIPPINCOTT WILLIAMS & WILKINS | Published : 2007

Abstract

OBJECTIVE: To compare primary resection and anastomosis (PRA) with and without defunctioning stoma to Hartmann's procedure (HP) as the optimal operative strategy for patients presenting with Hinchey stage III-IV, perforated diverticulitis. SUMMARY BACKGROUND DATA: The choice of operation for perforated diverticulitis lies between HP and PRA. Postoperative mortality and morbidity can be high, and the long-term consequences life-altering, with no established criteria guiding clinicians towards selecting a particular procedure. METHODS: Probability estimates for 6879 patients with Hinchey III-IV perforated diverticulitis were obtained from two databases (n = 204), supplemented by expert opinion..

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