Old-Fashioned Surgery for Perforated Diverticulitis Is Still Better

Some observational studies have suggested that outcomes of surgical treatment for perforated acute diverticulitis may be better with laparoscopic peritoneal lavage than with traditional colon resection with or without diversion. However, a recent randomized trial of the two techniques involving 90 patients with purulent perforated diverticulitis was terminated early because of an increased rate of adverse events with laparoscopic lavage (Lancet 2015; 386:1269).

To compare these two surgical approaches further, investigators conducted a randomized, controlled, open-label study involving 199 patients presenting with diverticulitis showing free air on abdominal computed tomography scans at 21 centers in Sweden and Norway.

The rate of severe post…