Damage Control Surgery in the Treatment of Complicated Diverticulitis

NCT03337984 | Completed

• 1 other identifier: EM-SURG AOSA 2017_1
• Study Type: observational
• Target: 121
• Locations: 1 country
• Sites: 9

Brief Summary

To evaluate the use of damage control surgery by performing bowel resection and laparostomy in the treatment of Hinchey III or IV diverticulitis.

Conditions

Diverticulitis

Keywords

Diverticulitis; Damage Control Surgery

Outcome Measures

Primary Outcomes (1)

• Mortality

  Mortality rate related to treatment

  6 months

Secondary Outcomes (4)

• Morbidity

  6 months

• Lenght of stay (LOS)

  6 months

• ICU lenght of stay

  12 months

• Number of Hartmann's procedure

  1 month

Eligibility Criteria

• Sex: all
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients operated on for Hinchey III or IV class and treated by damage control surgery procedure

You may qualify if:

• Patients undergoing surgery for Hinchey III and IV stage scheduled for immediate Hartmann's procedure and ICU recovery

You may not qualify if:

• None

Sponsors & Collaborators

• University of Roma La Sapienza: lead

Study Sites (9)

Policlinico San Pietro

Ponte San Pietro, Bergamo, Italy

Location

Azienda Ospedaliera Cardarelli

Napoli, Campania, Italy

Location

Ospedale Civile di Adria

Adria, Rovigo, Italy

Location

Azienda Ospedaliero Universitaria Ospedale Riuniti Ancona

Ancona, The Marches, 60121, Italy

Location

Ospedale San Donato

Arezzo, Tuscany, 52100, Italy

Location

Azienda Ospedaliera Pisana Policlinico Universitario Cisanello

Pisa, Tuscany, 56121, Italy

Location

Ospedale San Giovanni Battista

Foligno, Umbria, 06034, Italy

Location

Azienda Ospedaliera Santa Maria

Terni, Umbria, Italy

Location

Policlinico Abano Terme

Abano Terme, Veneto, 35031, Italy

Location

Related Publications (20)

• Costa G, La Torre M, Frezza B, Fransvea P, Tomassini F, Ziparo V, Balducci G. Changes in the surgical approach to colonic emergencies during a 15-year period. Dig Surg. 2014;31(3):197-203. doi: 10.1159/000365254. Epub 2014 Aug 28.

  PMID: 25170867 BACKGROUND

• Ince M, Stocchi L, Khomvilai S, Kwon DS, Hammel JP, Kiran RP. Morbidity and mortality of the Hartmann procedure for diverticular disease over 18 years in a single institution. Colorectal Dis. 2012 Aug;14(8):e492-8. doi: 10.1111/j.1463-1318.2012.03004.x.

  PMID: 22356208 BACKGROUND

• Turley RS, Barbas AS, Lidsky ME, Mantyh CR, Migaly J, Scarborough JE. Laparoscopic versus open Hartmann procedure for the emergency treatment of diverticulitis: a propensity-matched analysis. Dis Colon Rectum. 2013 Jan;56(1):72-82. doi: 10.1097/DCR.0b013e3182749cf5.

  PMID: 23222283 BACKGROUND

• Benz D, Balogh ZJ. Damage control surgery: current state and future directions. Curr Opin Crit Care. 2017 Dec;23(6):491-497. doi: 10.1097/MCC.0000000000000465.

  PMID: 29035926 BACKGROUND

• Girard E, Abba J, Boussat B, Trilling B, Mancini A, Bouzat P, Letoublon C, Chirica M, Arvieux C. Damage Control Surgery for Non-traumatic Abdominal Emergencies. World J Surg. 2018 Apr;42(4):965-973. doi: 10.1007/s00268-017-4262-6.

  PMID: 28948335 BACKGROUND

• Bruns BR, Ahmad SA, O'Meara L, Tesoriero R, Lauerman M, Klyushnenkova E, Kozar R, Scalea TM, Diaz JJ. Nontrauma open abdomens: A prospective observational study. J Trauma Acute Care Surg. 2016 Apr;80(4):631-6. doi: 10.1097/TA.0000000000000958.

  PMID: 26808023 BACKGROUND

• Weber DG, Bendinelli C, Balogh ZJ. Damage control surgery for abdominal emergencies. Br J Surg. 2014 Jan;101(1):e109-18. doi: 10.1002/bjs.9360. Epub 2013 Nov 25.

  PMID: 24273018 BACKGROUND

• Khan A, Hsee L, Mathur S, Civil I. Damage-control laparotomy in nontrauma patients: review of indications and outcomes. J Trauma Acute Care Surg. 2013 Sep;75(3):365-8. doi: 10.1097/TA.0b013e31829cb65e.

  PMID: 23928745 BACKGROUND

• Subramanian A, Balentine C, Palacio CH, Sansgiry S, Berger DH, Awad SS. Outcomes of damage-control celiotomy in elderly nontrauma patients with intra-abdominal catastrophes. Am J Surg. 2010 Dec;200(6):783-8; discussion 788-9. doi: 10.1016/j.amjsurg.2010.07.027.

  PMID: 21146021 BACKGROUND

• Cirocchi R, Arezzo A, Vettoretto N, Cavaliere D, Farinella E, Renzi C, Cannata G, Desiderio J, Farinacci F, Barberini F, Trastulli S, Parisi A, Fingerhut A. Role of damage control surgery in the treatment of Hinchey III and IV sigmoid diverticulitis: a tailored strategy. Medicine (Baltimore). 2014 Nov;93(25):e184. doi: 10.1097/MD.0000000000000184.

  PMID: 25437034 BACKGROUND

• Cassini D, Miccini M, Manoochehri F, Gregori M, Baldazzi G. Emergency Hartmann's Procedure and Its Reversal: A Totally Laparoscopic 2-Step Surgery for the Treatment of Hinchey III and IV Diverticulitis. Surg Innov. 2017 Dec;24(6):557-565. doi: 10.1177/1553350617722226. Epub 2017 Jul 27.

  PMID: 28748737 BACKGROUND

• Bridoux V, Regimbeau JM, Ouaissi M, Mathonnet M, Mauvais F, Houivet E, Schwarz L, Mege D, Sielezneff I, Sabbagh C, Tuech JJ. Hartmann's Procedure or Primary Anastomosis for Generalized Peritonitis due to Perforated Diverticulitis: A Prospective Multicenter Randomized Trial (DIVERTI). J Am Coll Surg. 2017 Dec;225(6):798-805. doi: 10.1016/j.jamcollsurg.2017.09.004. Epub 2017 Sep 22.

  PMID: 28943323 BACKGROUND

• Coccolini F, Montori G, Ceresoli M, Catena F, Moore EE, Ivatury R, Biffl W, Peitzman A, Coimbra R, Rizoli S, Kluger Y, Abu-Zidan FM, Sartelli M, De Moya M, Velmahos G, Fraga GP, Pereira BM, Leppaniemi A, Boermeester MA, Kirkpatrick AW, Maier R, Bala M, Sakakushev B, Khokha V, Malbrain M, Agnoletti V, Martin-Loeches I, Sugrue M, Di Saverio S, Griffiths E, Soreide K, Mazuski JE, May AK, Montravers P, Melotti RM, Pisano M, Salvetti F, Marchesi G, Valetti TM, Scalea T, Chiara O, Kashuk JL, Ansaloni L. The role of open abdomen in non-trauma patient: WSES Consensus Paper. World J Emerg Surg. 2017 Aug 14;12:39. doi: 10.1186/s13017-017-0146-1. eCollection 2017.

  PMID: 28814969 BACKGROUND

• Kafka-Ritsch R, Birkfellner F, Perathoner A, Raab H, Nehoda H, Pratschke J, Zitt M. Damage control surgery with abdominal vacuum and delayed bowel reconstruction in patients with perforated diverticulitis Hinchey III/IV. J Gastrointest Surg. 2012 Oct;16(10):1915-22. doi: 10.1007/s11605-012-1977-4. Epub 2012 Jul 28.

  PMID: 22843083 BACKGROUND

• Perathoner A, Klaus A, Muhlmann G, Oberwalder M, Margreiter R, Kafka-Ritsch R. Damage control with abdominal vacuum therapy (VAC) to manage perforated diverticulitis with advanced generalized peritonitis--a proof of concept. Int J Colorectal Dis. 2010 Jun;25(6):767-74. doi: 10.1007/s00384-010-0887-8. Epub 2010 Feb 11.

  PMID: 20148255 BACKGROUND

• Sohn M, Agha A, Heitland W, Gundling F, Steiner P, Iesalnieks I. Damage control strategy for the treatment of perforated diverticulitis with generalized peritonitis. Tech Coloproctol. 2016 Aug;20(8):577-83. doi: 10.1007/s10151-016-1506-7. Epub 2016 Jul 22.

  PMID: 27448296 BACKGROUND

• Hess GF, Schafer J, Rosenthal R, Kettelhack C, Oertli D. Reversal after Hartmann's procedure in patients with complicated sigmoid diverticulitis. Colorectal Dis. 2017 Jun;19(6):582-588. doi: 10.1111/codi.13553.

  PMID: 27805772 BACKGROUND

• Vennix S, Boersema GS, Buskens CJ, Menon AG, Tanis PJ, Lange JF, Bemelman WA. Emergency Laparoscopic Sigmoidectomy for Perforated Diverticulitis with Generalised Peritonitis: A Systematic Review. Dig Surg. 2016;33(1):1-7. doi: 10.1159/000441150. Epub 2015 Nov 10.

  PMID: 26551040 BACKGROUND

• Richards CH, Roxburgh CS; Scottish Surgical Research Group (SSRG). Surgical outcome in patients undergoing reversal of Hartmann's procedures: a multicentre study. Colorectal Dis. 2015 Mar;17(3):242-9. doi: 10.1111/codi.12807.

  PMID: 25331720 BACKGROUND

• Horesh N, Lessing Y, Rudnicki Y, Kent I, Kammar H, Ben-Yaacov A, Dreznik Y, Tulchinsky H, Avital S, Mavor E, Wasserberg N, Kashtan H, Klausner JM, Gutman M, Zmora O. Considerations for Hartmann's reversal and Hartmann's reversal outcomes-a multicenter study. Int J Colorectal Dis. 2017 Nov;32(11):1577-1582. doi: 10.1007/s00384-017-2897-2. Epub 2017 Sep 6.

  PMID: 28879552 BACKGROUND

MeSH Terms

Conditions

Diverticulitis

Condition Hierarchy (Ancestors)

Diverticular Diseases; Gastroenteritis; Gastrointestinal Diseases; Digestive System Diseases

Study Officials

• Gianluca Costa, MD, PhD

  University of Roma La Sapienza, Sant' Andrea University Hospital

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: OTHER
• Target Duration: 6 Months
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Study Creator and Director

Study Record Dates

• First Submitted: June 12, 2017
• First Posted: November 9, 2017
• Study Start: September 1, 2017
• Primary Completion: December 30, 2020
• Study Completion: December 30, 2020
• Last Updated: May 18, 2021

Record last verified: 2021-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: Since six months from study start to six months from study completion
• Access Criteria: By request

Locations

IT (9)