PERITONEAL LAUNCH OR SIGMOIDECTOMY? COMPARATIVE ANALYSIS IN THE MANAGEMENT OF COMPLICATED ACUTE DIVERTICULITIS

Abstract

Acute complicated diverticulitis is a condition that can lead to serious complications such as perforation, abscess or peritonitis. Appropriate treatment is essential to reduce the morbidity and mortality associated with this condition. Two surgical approaches have been widely used: sigmoidectomy and diagnostic peritoneal lavage. We conducted an integrative literature review to identify studies that compared sigmoidectomy with diagnostic peritoneal lavage in the treatment of complicated acute diverticulitis. We included retrospective and prospective studies that evaluated outcomes such as mortality, morbidity, length of stay, postoperative complications and quality of life. Sigmoidectomy is often associated with a higher rate of resolution of complicated acute diverticulitis, as it removes the source of infection. However, sigmoidectomy is a more invasive surgery and may be related to higher post-operative morbidity, including complications such as fistulas, stenosis and wound infections. On the other hand, diagnostic peritoneal lavage, which consists of drainage and irrigation of the abdomen, is a less invasive approach, but may be associated with a higher recurrence rate of complicated acute diverticulitis. Sigmoidectomy tends to be more effective in eliminating the source of infection, while diagnostic peritoneal lavage may be a viable option for frail patients or those with contraindications to more invasive surgery. This study aims to carry out a comparative analysis of these two strategies in the treatment of complicated acute diverticulitis.