American journal of surgery · 2025
Current urgent and emergent management of acute sigmoid diverticulitis … has the LADIES trial impacted change in surgical management at a single institution?
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stevens Nicholas, Gao-Gibbons Raisa, Wyland Clayton, Flewelling Kayla, McGoff Theresa, Brubaker Austin, McCahill Laurence E
Аннотация
INTRODUCTION: For perforated sigmoid diverticulitis, the "gold standard" has traditionally been the Hartmann's Procedure (HP). The LADIES trial published in 2019 suggested that primary anastomosis (PA) is safe. Our study aims to evaluate whether the LADIES trial has influenced the surgical management of perforated diverticulitis at our institution.
METHODS: Retrospective cohort study of patients undergoing urgent or emergent colectomy for perforated diverticulitis, divided into Group 1 (2013-2019) and Group 2 (post LADIES Trial, 2020-2024). Inclusion criteria was similar to the LADIES trial and included patients 85 years or younger, not immunocompromised, and without preoperative vasopressor requirements.
RESULTS: There were 88 patients total, 41 patients in Group 1 and 47 in Group 2. No significant difference was noted in procedure performed, though there was an upwards trend for performing PA (19.5 % vs 36.2 %, p = 0.084) and creation of protective ileostomy (7.3 % vs 19.2 %, p = 0.129) in Group2.
CONCLUSION: After publication in 2019, our institution demonstrated limited adoption of the LADIES trial for surgical management of perforated diverticulitis. Further study is required to better delineate surgeon continued reluctance for PA in this setting.
METHODS: Retrospective cohort study of patients undergoing urgent or emergent colectomy for perforated diverticulitis, divided into Group 1 (2013-2019) and Group 2 (post LADIES Trial, 2020-2024). Inclusion criteria was similar to the LADIES trial and included patients 85 years or younger, not immunocompromised, and without preoperative vasopressor requirements.
RESULTS: There were 88 patients total, 41 patients in Group 1 and 47 in Group 2. No significant difference was noted in procedure performed, though there was an upwards trend for performing PA (19.5 % vs 36.2 %, p = 0.084) and creation of protective ileostomy (7.3 % vs 19.2 %, p = 0.129) in Group2.
CONCLUSION: After publication in 2019, our institution demonstrated limited adoption of the LADIES trial for surgical management of perforated diverticulitis. Further study is required to better delineate surgeon continued reluctance for PA in this setting.