The Damage Control Strategy for the Treatment of Perforated Diverticulitis of the Sigmoid Colon With Diffuse Peritonitis
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ClinicalTrials.gov Identifier: NCT04220840 |
Recruitment Status :
Recruiting
First Posted : January 7, 2020
Last Update Posted : September 8, 2023
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The best approach for the treatment of perforated diverticulitis of the sigmoid colon is still under debate. Concurrent techniques are 1) resection with primary colorectal anastomosis with or without additional loop ileostomy; 2) end colostomy (Hartmann´s procedure); 3) Damage control strategy; 4) laparoscopic lavage and placement of a drainage. It is hypothesized, that the use of the damage control strategy leads to a significant reduction of the stoma rate.
The damage control strategy constitutes a two stage procedure.
Emergency surgery:
limited resection of the diseased colonic segment with oral and aboral blind closure, abdominal lavage, temporary vacuum assisted abdominal closure
Second look surgery (48-72 hours later):
Reexploration with
- definite reconstruction (Colorectal anastomosis -/+ diverting ileostomy vs. end colostomy)
- lavage, vacuum assisted abdominal closure, third look 72 hours after emergency surgery
Within the study, data of DCS-procedures will be collected retrospectively in a multicentric and transnational approach. Those will be compared to a cohort of patients treated with a "no-DCS"-technique (resection with primary anastomosis or Hartmann´s procedure).
Condition or disease | Intervention/treatment |
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Perforated Diverticulitis | Procedure: Damage control strategy |
Study Type : | Observational |
Estimated Enrollment : | 600 participants |
Observational Model: | Case-Control |
Time Perspective: | Retrospective |
Official Title: | The Damage Control Strategy for the Treatment of Perforated Diverticulitis of the Sigmoid Colon With Diffuse Peritonitis - a Retrospective, Multicenter, Transnational Cohort Study |
Actual Study Start Date : | November 1, 2020 |
Estimated Primary Completion Date : | December 1, 2023 |
Estimated Study Completion Date : | June 1, 2024 |
Group/Cohort | Intervention/treatment |
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Study Group
All consecutive patients who underwent damage control surgery (DCS) for perforated diverticulitis of the sigmoid colon with generalized Peritonitis in one of the participating centers
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Procedure: Damage control strategy
The damage control strategy constitutes a two stage procedure. Emergency surgery: limited resection oft he diseased colonic segment with oral and aboral blind closure, abdominal lavage, temporary vacuum assisted abdominal closure Second look surgery (48-72 hours later): reexploration with
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Control group
All consecutive patients who underwent other than DCS surgery (resection with primary anastomosis, Hartmann´s procedure, laparoscopic lavage) for perforated diverticulitis of the sigmoid colon with generalized Peritonitis in one of the participating centers which do not apply DCS routinely.
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Procedure: Damage control strategy
The damage control strategy constitutes a two stage procedure. Emergency surgery: limited resection oft he diseased colonic segment with oral and aboral blind closure, abdominal lavage, temporary vacuum assisted abdominal closure Second look surgery (48-72 hours later): reexploration with
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- Stoma rate at the end of the index hospital stay [ Time Frame: 30 days after surgery for definite reconstruction ]rate of enterostomies (Loop ileostomy and end colostomy) at the end of the hospital stay, associated to the emergency operation
- Stoma rate over the long term [ Time Frame: through study completion, an average of 1 year ]rate of enterostomies (Loop ileostomy and end colostomy) at the end of the follow-up
- 30-day Morbidity [ Time Frame: 30 days after surgery for definite reconstruction ]Morbidity assessed by the Clavien-Dindo classification
- 30-day Mortality [ Time Frame: 30 days after surgery for definite reconstruction ]Mortality
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Ages Eligible for Study: | Child, Adult, Older Adult |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
all patients who were operated for perforated diverticulitis with generalized peritonitis
Exclusion Criteria:
incomplete data sets
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04220840
Germany | |
Dr. Maximilian Sohn | Recruiting |
Munich, Bavaria, Germany, 81925 | |
Contact: Maximilian Sohn, M.D., Dr. med. +49-89-9270702756 maximilian.sohn@klinikum-muenchen.de | |
Contact: Igors Iesalnieks, M.D., Prof. Dr. med. +49-9270702125 igors.iesalnieks@klinikum-muenchen.de |
Responsible Party: | Dr. Maximilian Sohn, M.D., Dr. med., Attending Surgeon, Städtisches Klinikum München GmbH |
ClinicalTrials.gov Identifier: | NCT04220840 |
Other Study ID Numbers: |
DCS-INT-2020 |
First Posted: | January 7, 2020 Key Record Dates |
Last Update Posted: | September 8, 2023 |
Last Verified: | September 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Peritonitis Diverticulitis Intraabdominal Infections Infections Peritoneal Diseases |
Digestive System Diseases Diverticular Diseases Gastroenteritis Gastrointestinal Diseases |