{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:57:43Z","timestamp":1776164263928,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,5,4]],"date-time":"2006-05-04T00:00:00Z","timestamp":1146700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Guidelines for the treatment of complicated sigmoid diverticulitis recommend Hartmann\u2019s procedure or anastomosis with protective colostomy for Hinchey stage III diverticulitis and Hartmann\u2019s procedure only for Hinchey stage IV diverticulitis. We evaluated the outcome of patients with perforated sigmoid diverticulitis Hinchey III\/IV undergoing one\u2010stage colon resection and primary anastomosis without protective colostomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After implementation of a protocol to treat Hinchey III\/IV diverticulitis with primary anastomosis without protective ileocolostomy, the patients\u2019 data were recorded prospectively between August 2001 and August 2003 and analyzed retrospectively from a computer\u2010related database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 41 patients, 34 (81%%) underwent one\u2010stage sigmoid resection and primary anastomosis, 3 of 41 patients (7%%) underwent primary anatomosis with protective ileostomy, and 5 of 41 patients (12%%) had a Hartmann\u2019s procedure. The mortality was 11%% in patients undergoing primary anastomosis and 60%% in patients with Hartmann\u2019s procedure. The relative risk of co\u2010morbidity factors for lethal outcome after sigmoid resection was 6.94 for preceding operations, 3.75 for renal failure or renal transplantation, and 3.25 for immunosuppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>One\u2010stage sigmoid resection and primary anastomosis can be performed safely in nearly 90%% of all patients with perforated sigmoid diverticulitis (Hinchey III\/IV) by surgeons of different training levels. Patients with immunosuppression, chronic renal failure, liver cirrhosis, or previous organ transplantation or complex cardiovascular reconstructive procedures have a significantly increased risk of dying after sigmoid resection for perforated diverticulitis.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-005-0439-5","type":"journal-article","created":{"date-parts":[[2006,5,11]],"date-time":"2006-05-11T14:49:57Z","timestamp":1147358997000},"page":"1027-1032","source":"Crossref","is-referenced-by-count":72,"title":["One\u2010stage Sigmoid Colon Resection for Perforated Sigmoid Diverticulitis (Hinchey Stages III and IV)"],"prefix":"10.1002","volume":"30","author":[{"given":"Sven","family":"Richter","sequence":"first","affiliation":[{"name":"Clinic of General, Visceral, Vascular, and Pediatric Surgery University Hospital of the Saarland Kirrberger Strasse D\u201066421 Homburg\/Saar Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Werner","family":"Lindemann","sequence":"additional","affiliation":[{"name":"Clinic of General, Visceral, Vascular, and Pediatric Surgery University Hospital of the Saarland Kirrberger Strasse D\u201066421 Homburg\/Saar Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Otto","family":"Kollmar","sequence":"additional","affiliation":[{"name":"Clinic of General, Visceral, Vascular, and Pediatric Surgery University Hospital of the Saarland Kirrberger Strasse D\u201066421 Homburg\/Saar Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg A.","family":"Pistorius","sequence":"additional","affiliation":[{"name":"Clinic of General, Visceral, Vascular, and Pediatric Surgery University Hospital of the Saarland Kirrberger Strasse D\u201066421 Homburg\/Saar Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph A.","family":"Maurer","sequence":"additional","affiliation":[{"name":"Surgical Clinic Hospital of Liestal Rheinstrasse 26 CH\u20104410 Liestal Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin K.","family":"Schilling","sequence":"additional","affiliation":[{"name":"Clinic of General, Visceral, Vascular, and Pediatric Surgery University Hospital of the Saarland Kirrberger Strasse D\u201066421 Homburg\/Saar Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,5,4]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"85","article-title":"Treatment of perforated diverticular disease of the colon","volume":"12","author":"Hinchey EJ","year":"1978","journal-title":"Adv Surg"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800800434"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02258290"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02258291"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004649901007"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800711202"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(97)00272\u20109"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1996.01430180038006"},{"key":"e_1_2_6_10_2","first-page":"239","article-title":"Reversal of Hartmann\u2019s colostomy","volume":"39","author":"Khan AL","year":"1994","journal-title":"J R Coll Surg Edinb"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010002\u20106699\u20104"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2000.101583"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234569"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234570"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109610(84)90429\u2010X"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1991.01410310065009"},{"key":"e_1_2_6_17_2","first-page":"84","article-title":"Der Mannheimer Peritonitis Index: ein Instrument zur intraoperativen Prognose der Peritonitis","volume":"58","author":"Linder MM","year":"1987","journal-title":"Chirurg"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102168.2000.01552.x"},{"key":"e_1_2_6_19_2","doi-asserted-by":"crossref","unstructured":"GuenagaKF MatosD CastroAA et al. 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