alexa Non-Elective Surgery for Acute Complicated Diverticulitis. Primary Resection-Anastomosis or Hartmann’s Procedure? A Systematic Review and Meta-Analysis
[Jurnalul de Chirurgie]
ISSN: 1584-9341

Journal of Surgery
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Editorial

Non-Elective Surgery for Acute Complicated Diverticulitis. Primary Resection-Anastomosis or Hartmann’s Procedure? A Systematic Review and Meta-Analysis

Dionigi Lorusso1*, Aurore Giliberti2, Margherita Bianco2 and Gioacchino3

1Department of Surgery, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Castellana Grotte, Bari, Italy

2Trial Center, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Castellana Grotte, Bari, Italy

3Department of Gastroenterology, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Castellana Grotte, Bari, Italy

*Corresponding Author:
Lorusso D
Department of Surgery, Scientific Institute for Digestive Disease
"Saverio de Bellis" Hospital Via Turi, 27-70013 – Castellana Grotte, Italy
Tel: +390804994170
Fax: +390804994292
E-mail: [email protected]

Received Date: June 19, 2016; Accepted Date: June 21, 2016; Published Date: June 27, 2016

Citation: Lorusso D, Giliberti A, Bianco M, Gioacchino. Non-Elective Surgery for Acute Complicated Diverticulitis. Primary Resection-Anastomosis or Hartmann’s Procedure? A Systematic Review and Meta-Analysis. Journal of Surgery [Jurnalul de chirurgie]. 2016; 12(2): 43-49 DOI:10.7438/1584-9341-12-2-1

Copyright: © 2016 Lorusso D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Background: The use of Primary Resection-Anastomosis with or without protective ileostomy (PRA) or Hartmann’s Procedure (HP) in the surgery of complicated acute diverticulitis is still an open question. The latest published meta-analyses were limited to the most severe stages (Hinchey III and IV). Our systematic review aimed to compare PRA with the HP in all non-elective surgical patients with complicated acute diverticulitis (perforation or obstruction). Methods: A computerized literature search was performed on Medline databases until July 2014. The studies included in the meta-analysis were 24 with a total of 4,062 patients. Study outcomes included postoperative surgical complications, reintervention, 30-day mortality, overall mortality as well as the length of stay as secondary outcome. The pooled effects were estimated using a fixed effect model or random effect model based on the heterogeneity test. Results were expressed as odds ratio (OR) and 95% confidence interval (CI) for dichotomous outcomes and as mean difference (MD) with 95% CI for continuous outcomes. Subgroup analyses by study type were performed. Results: The PRA group had a lower rate of postoperative surgical complications (OR=0.525, 95% CI 0.387-0.713), reintervention (OR=0.688, 95% CI 0.525-0.902), 30-day mortality (OR=0.389, 95% CI 0.259-0.586), overall mortality (OR=0.467, 95% CI 0.272-0.803) and length of stay (MD=9.129, 95% CI 2.391-15.867) compared to the HP group. Conclusion: Our meta-analysis shows that the PRA technique is better than HP for all considered outcomes. Due to the high variability of the included studies, further randomized controlled trials would be required to confirm these results.

Keywords

Share This Page

Additional Info

Loading
Loading Please wait..
 
Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

neuro_psycho[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords