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Comment & Response
July 28, 2021

Long-term Outcomes of Laparoscopic Lavage for Perforated Diverticulitis Remain Unfavorable

Author Affiliations
  • 1Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
  • 2Department of Surgery, St Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
  • 3Li Ka Sing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
JAMA Surg. 2021;156(11):1070-1071. doi:10.1001/jamasurg.2021.3305

To the Editor Laparoscopic lavage has been promoted to treat purulent perforated diverticulitis in hopes that patients may avoid major morbidity from sigmoid resection including anastomotic leak and a stoma. However, 3 randomized clinical trials, the Laparoscopic Lavage (LOLA), Diverticulitis–Laparoscopic Lavage (DILALA), and Scandinavian Diverticulitis (SCANDIV) trials, have compared laparoscopic lavage vs sigmoid resection for Hinchey III diverticulitis, and pooled results indicate that laparoscopic lavage leads to more severe complications than sigmoid resection (35% vs 20%; relative risk, 1.68; 95% CI, 1.10-2.56).1

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