Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Colorectal Dis. 2010 Sep;12(9):862-7. doi: 10.1111/j.1463-1318.2009.02052.x. Epub 2009 Sep 26.
This systematic review aimed to evaluate the efficacy, morbidity and mortality of laparoscopic peritoneal lavage for patients with perforated diverticulitis.
We searched PubMed, EMBASE, Web of Science, the Cochrane Library and CINAHL databases, Google Scholar and five major publisher websites without language restriction. All articles which reported the use of laparoscopic peritoneal lavage for patients with perforated diverticulitis were included.
Two prospective cohort studies, nine retrospective case series and two case reports reporting 231 patients were selected for data extraction. Most (77%) patients had purulent peritonitis (Hinchey III). Laparoscopic peritoneal lavage successfully controlled abdominal and systemic sepsis in 95.7% of patients. Mortality was 1.7%, morbidity 10.4% and only four (1.7%) of the 231 patients received a colostomy.
There have been no publications of high methodological quality on laparoscopic peritoneal lavage for patients with perforated colonic diverticulitis. The published papers do, however, show promising results, with high efficacy, low mortality, low morbidity and a minimal need for a colostomy.
本系统评价旨在评估腹腔镜腹腔灌洗治疗穿孔性憩室炎患者的疗效、发病率和死亡率。
我们检索了 PubMed、EMBASE、Web of Science、Cochrane 图书馆和 CINAHL 数据库、Google Scholar 以及五个主要出版商的网站，不限制语言。所有报告腹腔镜腹腔灌洗治疗穿孔性憩室炎患者的文章均被纳入。
有 2 项前瞻性队列研究、9 项回顾性病例系列研究和 2 项病例报告共纳入 231 例患者的数据进行提取。大多数（77%）患者患有脓性腹膜炎（Hinchey III 级）。腹腔镜腹腔灌洗成功控制了 95.7%的患者的腹部和全身脓毒症。死亡率为 1.7%，发病率为 10.4%，231 例患者中只有 4 例（1.7%）接受了结肠造口术。
对于穿孔性结肠憩室炎患者，尚无腹腔镜腹腔灌洗治疗的高质量方法学研究发表。然而，已发表的论文显示了有前景的结果，具有高疗效、低死亡率、低发病率和最小需要结肠造口术的特点。
