Functional Outcomes of Emergency Surgery for Perforated Diverticulitis, Hinchey Grade III

Abstract

BackgroundLaparoscopic lavage as a treatment for perforated diverticulitis, Hinchey III, has been found safe and feasible in randomized trials. A few studies have reported functional outcomes and quality of life as secondary outcomes. This study investigated distress associated with dysfunction of the bowel or stoma, functional outcomes, and quality of life 2–3 years after surgery in a national unselected cohort.MethodsAll patients in Sweden who underwent emergency surgery for perforated diverticulitis with purulent peritonitis (2016–2018) were invited to answer a comprehensive, study-specific questionnaire 2–3 years after the index surgery.ResultsOut of 499 potential patients, 226 returned the questionnaire, and 209 were included in the analysis. There was no statistically significant difference between laparoscopic lavage and resection in distress associated with dysfunction of the bowel or stoma (odds ratio [OR], 1.32 [95% CI, 0.91–1.92]; p = 0.015). Bowel dysfunction measured by the LARS score was significantly higher for the lavage group (OR, 1.65 [95% CI, 1.11–2.45]), while stoma was more frequent after resection surgery (40 vs 6%).ConclusionsPatients experienced long-term distress from bodily dysfunction after emergency surgery for perforated diverticulitis regardless of the technique used. Regular follow-up could benefit these patients.Trial RegistrationThe project was registered at ClinicalTrials.gov on 2017–11-06. Identifier: NCT03332550. Acronym: LapLav.