Avancées récentes dans la prise en charge chirurgicale des péritonites diverticulaires Hinchey III et IV

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• 作者：C. Hobeika ; J. Lefevre
• 关键词：Mots clésDiverticulite ; Péritonite ; Hinchey ; Hartmann ; Lavage ; Résection
• 刊名：Côlon & Rectum
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：11
• 期：1
• 页码：19-24
• 全文大小：
• 刊物主题：Medicine/Public Health, general; Proctology; Gastroenterology; Colorectal Surgery; Surgery; Imaging / Radiology;
• 出版者：Lavoisier
• ISSN：1951-638X
• 卷排序：11

文摘

Perforated diverticulitis occurs in 3 to 4/100.000 persons each year. French guidelines published in 2006 recommend colonic resection in case of peritonitis (Hinchey 3 and 4). Hartmann’s procedure used to be the gold standard but remains debated particularly in case of Hinchey 3 peritonitis. Primary anastomosis has been suggested in several articles as an alternative to Hartmann’s procedure with promising results. Early in the 2000’s, several articles reported initial experience of laparoscopic lavage and drainage in case of Hinchey 3 peritonitis also. Two recent randomized studies failed to demonstrate the superiority of this innovative approach. To date, colonic resection with primary anastomosis seems to be feasible and secure and can be proposed instead of Hartmann’s procedure in case of Hinchey 3 peritonitis. In case of Hinchey 4 peritonitis, no clear conclusion can be drawn after exhaustive analysis of the literature.