Background:
Damage control surgery with peritoneal lavage represents the gold standard for the
management of perforated diverticulitis mit generalized peritonitis. Data on staged
peritoneal lavage following damage control surgery is not available. The aim of this
study was to investigate the outcomes of patients managed with staged lavage for peritonitis
after damage control surgery.
Materials and methods:
This is a single center retrospective analysis. The data of patients undergoung staged
lavaged for the management of peritonitis in the setting of perforated diverticulitis
was analyzed. Outcome measured included the number of staged lavage, in-hospital mortality
and the rate of abdominal wall closure.
Results:
24 patients (13 females and 11 males): median age of 67.0yrs, ASA scores ≤2 in 10
cases, and ASA scores > 2 in 14 cases, managed within a 5 – year peroid from 2013
to 2017 were identifies from our departmental records. Preoperative Ct- scans were
reviewed to confirm the indication for surgery. Median WBC, CRP and PCT were 12.6/µl,
54.5 mg/l and and 1,2 ng/ml respectively. Three staged lavages were done in median,
range 1 – 11. Median length of stay was 18 days, abdominal wall closure was achieved
in all cases. The rate of mortality was 12.5% (three deaths).
Conclusion:
Staged lavage might represent a good adjunct to damage control surgery in the management
perforated diverticulitis with abdominal sepsis.
