Tim W. Eglinton, MBChB, MMedSc; Frank A. Frizelle, MBChB, MMedSc
This article was published at www.annals.org on 19 January 2016.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2788.
Requests for Single Reprints: Frank A. Frizelle, University of Otago, Christchurch, 2 Riccarton Avenue, Christchurch 8012, New Zealand; e-mail, Frank.Frizelle@cdhb.health.nz.
Current Author Addresses: Drs. Eglinton and Frizelle: University of Otago, Christchurch, 2 Riccarton Avenue, Christchurch 8012, New Zealand.
Eglinton TW, Frizelle FA. Trials of Surgical Treatment of Acute Perforated Diverticulitis: Finding What They Look For. Ann Intern Med. 2016;164:195-196. doi: 10.7326/M15-2788
Download citation file:
Published: Ann Intern Med. 2016;164(3):195-196.
Published at www.annals.org on 19 January 2016
Most patients with acute diverticulitis are managed conservatively with intravenous antibiotics and improve without requiring acute surgery. When surgery is required, the Hartmann procedure, which involves sigmoid resection and end colostomy, is most commonly used. This procedure is associated with significant morbidity and stoma formation. Thus, an alternative to the Hartmann procedure that achieved at least an equivalent outcome would be welcome. However, the challenge is to define the outcomes that are important and to whom.
In this issue, Thornell and colleagues (1) deserve congratulations for conducting a randomized, controlled trial called DILALA (DIverticulitis—LAparoscopic LAvage vs. resection [Hartman procedure] for acute diverticulitis with peritonitis). They studied a surgical method for the management of acute diverticulitis, a common, morbid, and costly disease. Randomized trials of surgical procedures are uncommon. Such trials are more difficult to orchestrate than drug trials because of cumulative therapeutic effects, operator dependence, various clinical settings, interdependence of short- and long-term outcomes, and agreement about equipoise (2).
Learn more about subscription options.
Register Now for a free account.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only