0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Laparoscopic Lavage vs Primary Resection for Perforated Diverticulitis

John Roberts, MD1
[+] Author Affiliations
1Northwest Permanente, Vancouver, Washington
JAMA. 2016;315(10):1052-1053. doi:10.1001/jama.2015.17867.
Text Size: A A A
Published online

Extract

To the Editor Dr Schultz and colleagues1 studied laparoscopic lavage vs colon resection for perforated diverticulitis. They reported no differences in severe postoperative complications, and 20% of patients needed further surgery after a laparoscopic lavage vs 6% after resection.

Should reoperation after a laparoscopic lavage be considered a complication? If having to perform a Hartmann procedure later in the patient’s treatment was considered a complication for the lavage group, then should not all primary Hartmann procedures have been considered complications as well? A Hartmann procedure is a morbid surgery requiring a large laparotomy. This procedure has long-term risks of incisional hernia, small-bowel obstruction, and colostomy (which will require a second major laparotomy for restoration of intestinal continuity). In the resection group, 70% of patients had this procedure up front.

Topics

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

March 8, 2016
Johannes Kurt Schultz, MD; Sheraz Yaqub, MD, PhD; Tom Øresland, MD, PhD
1Department of Gastrointestinal Surgery, Akershus University Hospital, Lørenskog, Norway
2Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway
3University of Oslo, Oslo, Norway
JAMA. 2016;315(10):1053-1054. doi:10.1001/jama.2015.17873.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

585 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
brightcove.createExperiences();