Staged peritoneal lavage as an adjunct to damage control surgery following perforated diverticulitis with generalized peritonitis. A single center experience.

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.