Resection with primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a systematic review and meta-analysis

Autor: Christian E. Oberkofler, Jean-Jacques Tuech, Roberto Bergamaschi, Dieter Hahnloser, Mahir Gachabayov
Přispěvatelé: University of Zurich, Bergamaschi, R
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
Operative Time
610 Medicine & health
Comorbidity
Peritonitis
Cochrane Library
Anastomosis
Risk Assessment
Gastroenterology
Diverticulitis
Colonic
law.invention
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Randomized controlled trial
law
Internal medicine
Colostomy
medicine
Humans
2715 Gastroenterology
Colectomy
Randomized Controlled Trials as Topic
10217 Clinic for Visceral and Transplantation Surgery
business.industry
Mortality rate
Anastomosis
Surgical
Odds ratio
Diverticulitis
Prognosis
medicine.disease
Survival Analysis
Treatment Outcome
Anastomosis
Surgical/adverse effects
Anastomosis
Surgical/methods
Colectomy/adverse effects
Colectomy/methods
Colostomy/adverse effects
Colostomy/methods
Diverticulitis
Colonic/diagnosis
Diverticulitis
Colonic/epidemiology
Diverticulitis
Colonic/surgery
Female
Intestinal Perforation/diagnosis
Intestinal Perforation/epidemiology
Intestinal Perforation/surgery
Peritonitis/diagnosis
Peritonitis/epidemiology
Peritonitis/surgery
Postoperative Complications/mortality
Postoperative Complications/physiopathology
Hartmann's procedure
Perforated diverticulitis
meta-analysis
peritonitis
primary anastomosis
Intestinal Perforation
030220 oncology & carcinogenesis
Number needed to treat
030211 gastroenterology & hepatology
business
Zdroj: Colorectal disease, vol. 20, no. 9, pp. 753-770
ISSN: 1462-8910
DOI: 10.1111/codi.14237
Popis: AIM It is still controversial whether the optimal operation for perforated diverticulitis with peritonitis is primary anastomosis (PRA) or nonrestorative resection (NRR). The aim of this systematic review and meta-analysis was to evaluate mortality and morbidity rates following emergency resection for perforated diverticulitis with peritonitis and ostomy reversal, as well as ostomy nonreversal rates. METHOD The Pubmed, EMBASE, Cochrane Library, MEDLINE via Ovid, CINAHL and Web of Science databases were systematically searched. Mortality was the primary end-point. A subgroup meta-analysis of randomized controlled trials was performed in addition to a meta-analysis of all eligible studies. Odds ratios (ORs) and mean difference (MD) were calculated for dichotomous and continuous outcomes, respectively. RESULTS Seventeen studies, including three randomized controlled trials (RCTs), involving 1016 patients (392 PRA vs 624 NRR) were included. Overall, mortality was significantly lower in patients with PRA compared with patients with NRR [OR (95% CI) = 0.38 (0.24, 0.60), P
Databáze: OpenAIRE
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