The purpose of this study is to collect a multi-institutional database including all relevant data regarding the surgical and clinical features of patients underwent to laparoscopic lavage for complicated colic diverticulitis. The main objectives are:~To determine the surgical and clinical outcomes, in the short and long term.~To compare results according to the different type of techniques, device used and manner of execution of the different surgical steps.~To relate results of different surgeries with baseline characteristics of patients and stage of disease.~This ad hoc registry will allow centers to retrospectively fill in the data of their patients; the information will be obtained from existing records, diagnostic tests and surgical intervention descriptions. Data will be collected and recorded by all institutions through a specific online shared system.~To facilitate and standardize data collection through a shared database and to ensure the safety of sensitive data, a special online computerized web system has been developed.~Investigators have to provide the required data as fully as possible; however, the lack of certain data does not preclude from sending the remaining data.~Specific aims~Analyze general outcome~Analyze the different techniques of laparoscopic lavage~Analyze the different inclusion criteria~Analyze the different follow-up~Primary outcome for this retrospective observational study is:~the success rate of laparoscopic peritoneal lavage, defined as the rate of patients alive with no need of further surgical treatment for recurrent attacks of diverticulitis.~Secondary outcomes are:~conversion to any form of laparoscopy different from peritoneal lavage (with or without bowel resection)~conversion to laparotomy (with or without bowel resection)~30 days post-operative mortality;~30 days post-operative surgical re-interventions rate;~30 days post-operative percutaneous drainage rate;~hospital readmission rate for recurrence of diverticulitis;~- rate of visualisation of colonic perforation during laparoscopic peritoneal lavage;~surgical strategies used in case of detection of a colonic perforation;~consistency, if any, of visceral adhesiolysis performed during the procedure;~duration of follow-up~post-lavage elective resection rate (lavage bridge to resection)~Eligibility Each patient is required to meet all of the inclusion criteria and none of the exclusion criteria.~Inclusion criteria Patients with colonic diverticulitis submitted to laparoscopic lavage~Exclusion criteria Patients with occasional finding of colo-rectal cancer~Data collection Patient demographics~Year of birth~Sex~Body Mass Index (BMI)~ASA score~Haemodynamic condition (stable or unstable)~Previous abdominal surgery~Previous events of diverticulitis requiring ambulatory investigation or treatment~Previous events of diverticulitis requiring hospitalization~Abdominal CT scan before surgery (yes/no) and WSES stage (Sartelli M, Moore FA, Ansaloni L, Di Saverio S, Coccolini F, Griffiths EA, et al. A proposal for a CT driven classification of left colon acute diverticulitis. World J Emerg Surg. 2015 World 2015; 10: 3) Surgery~Date of Operation~Hinchey score (modified Kaiser AM, Jiang JK, Lake JP, Ault G, Artinyan A, Gonzalez-Ruiz C, Essani R, Beart RW Jr. The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol 2005; 100: 910-917)~Number of trocars inserted~Quantity of lavage (cc)~Conversion rate to any laparoscopic technique either than lavage~Conversion rate to any type of open surgical technique~Degree of adhesiolysis performed for searching eventual free colonic perforation (1. none, 2. lysis of weak adhesions, 3. actively searching for any collection with consistent amount of adhesiolysis)~Identification of a free colonic perforation during the laparoscopic peritoneal lavage~Surgical strategies used in case of detection of a colonic perforation (drainage, stitching, resection)~Placement of intra-abdominal drain (number and location)~Operative time~Estimated blood loss~Intraoperative complications~Intraoperative death~Postoperative clinical findings~Length of postoperative hospital stays~Postoperative blood transfusion~Liquid diet (POD number)~Soft solid diet (POD number)~Re-establishment of peristalsis (POD number)~First pass of flatus (POD number)~Drain removal (POD number)~Length and type of intravenous antibiotic use~Length of intravenous analgesic use~In-hospital postoperative complications~Type of complication~Re-operation for complication~Dindo-Clavien Grade~Early and late surgery-related complications after discharge~Date of hospitalization for diverticulitis recurrence~Type of complication~Death related to the complication~Need of surgery (type of surgery)~Need percutaneous drainage~Need peritoneal lavage Follow-up~Date of last follow-up visit~post-Lap lavage elective resection rate (lavage as a bridge to resection)~Indication to resection (symptoms, prophilaxys of further episodes of acute diverticulitis)
The purpose of this study is to collect a multi-institutional database including all relevant data regarding the surgical and clinical features of patients underwent to laparoscopic lavage for complicated colic diverticulitis. The main objectives are:~To determine the surgical and clinical outcomes, in the short and long term.~To compare results according to the different type of techniques, device used and manner of execution of the different surgical steps.~To relate results of different surgeries with baseline characteristics of patients and stage of disease.