{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:36:12Z","timestamp":1793046972355,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,3,14]],"date-time":"2018-03-14T00:00:00Z","timestamp":1520985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,3,14]],"date-time":"2018-03-14T00:00:00Z","timestamp":1520985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Optimal surgical management of perforated diverticulitis of the sigmoid colon has yet to be clearly defined. The purpose of this study was to evaluate efficacy of a \u201cDamage Control Strategy\u201d (DCS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Patients with perforated diverticulitis of the sigmoid colon complicated by generalized peritonitis (Hinchey III and IV) surgically treated according to a damage control strategy between May 2011 and February 2017 were enrolled in the present multicenter retrospective cohort study. Data were collected at three surgical centers. DCS comprises a two\u2010stage concept: [1] limited resection of the perforated colon segment with oral and aboral blind closure during the emergency procedure and [2] definitive reconstruction at scheduled second laparotomy (anastomosis\u2009\u2213\u2009loop ileostomy or a Hartmann\u2019s procedure) after 24\u201348\u2009h.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010eight patients were included into the analysis [W:M 28:30, median age 70.1 years (30\u201392)]. Eleven patients (19%) initially presented with fecal peritonitis (Hinchey IV) and 47 patients with purulent peritonitis (Hinchey III). An anastomosis could be created during the second procedure in 48 patients (83%), 14 of those received an additional loop ileostomy. In the remaining ten patients (<jats:italic>n<\/jats:italic>\u2009=\u200917%), an end colostomy was created at second laparotomy. A fecal diversion was performed in five patients to treat anastomotic complications. Thus, altogether, 29 patients (50%) had stoma at the end of the hospital stay. The postoperative mortality was 9% (<jats:italic>n<\/jats:italic>\u2009=\u20095), and median postoperative hospital stay was 18.5\u00a0days (3\u201366). At the end of the follow\u2010up, 44 of 53 surviving patients were stoma free (83%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of the <jats:italic>Damage Control<\/jats:italic> strategy leads to a comparatively low stoma rate in patients suffering from perforated diverticulitis with generalized peritonitis.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4585-y","type":"journal-article","created":{"date-parts":[[2018,3,14]],"date-time":"2018-03-14T16:32:02Z","timestamp":1521045122000},"page":"3189-3195","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Perforated Diverticulitis with Generalized Peritonitis: Low Stoma Rate Using a \u201cDamage Control Strategy\u201d"],"prefix":"10.1002","volume":"42","author":[{"given":"Maximilian","family":"Sohn","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Allgemein\u2010, Viszeral\u2010, Endokrine\u2010 und minimalinvasive Chirurgie, Klinikum Bogenhausen St\u00e4dtisches Klinikum M\u00fcnchen GmbH Englschalkinger Strasse 77 81925 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Iesalnieks","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein\u2010, Viszeral\u2010, Endokrine\u2010 und minimalinvasive Chirurgie, Klinikum Bogenhausen St\u00e4dtisches Klinikum M\u00fcnchen GmbH Englschalkinger Strasse 77 81925 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Agha","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein\u2010, Viszeral\u2010, Endokrine\u2010 und minimalinvasive Chirurgie, Klinikum Bogenhausen St\u00e4dtisches Klinikum M\u00fcnchen GmbH Englschalkinger Strasse 77 81925 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Steiner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein, Viszeral\u2010 und Gef\u00e4\u00dfchirurgie\u2010, Klinikum Harlaching St\u00e4dtisches Klinikum M\u00fcnchen GmbH Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Hochrein","sequence":"additional","affiliation":[{"name":"OCM \u2013 M\u00fcnchen Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Pratschke","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Campus Charit\u00e9 Mitte|Campus Virchow\u2010Klinikum Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Ritschl","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Campus Charit\u00e9 Mitte|Campus Virchow\u2010Klinikum Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Aigner","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Campus Charit\u00e9 Mitte|Campus Virchow\u2010Klinikum Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,14]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00104\u2010013\u20102621\u2010x"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010010\u20101155\u20105"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350\u2010005\u20100168\u20108"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31827324ba"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00053\u2010016\u20100095\u20102"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2008.01667.x"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010012\u20101977\u20104"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010010\u20100887\u20108"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01586154\u2010201305000\u201000029"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000184"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010016\u20101506\u20107"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010011\u20101314\u20105"},{"key":"e_1_2_9_14_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_9_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00191581"},{"issue":"4","key":"e_1_2_9_16_2","first-page":"297","article-title":"The value of 2 distinct prognosis scores in patients with peritonitis. The Mannheim Peritonitis Index versus the Apache II score","volume":"61","author":"Rogy M","year":"1990","journal-title":"Chir Z F\u00fcr Alle Geb Oper Medizen"},{"issue":"9","key":"e_1_2_9_17_2","first-page":"598","article-title":"Validation study of the Mannheim Peritonitis Index","volume":"59","author":"F\u00fcgger R","year":"1988","journal-title":"Chir Z F\u00fcr Alle Geb Oper Medizen"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00390\u2010010\u20100249\u20103"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2012.03117.x"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010012\u20101622\u20104"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(97)89625\u20100"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6024"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.02052.x"},{"issue":"117","key":"e_1_2_9_24_2","first-page":"122","article-title":"Laparoscopic lavage is feasible and safe for the treatment of perforated diverticulitis with purulent peritonitis: the first results from the randomized controlled trial DILALA","volume":"263","author":"Angenete E","year":"2016","journal-title":"Ann Surg"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102482\u201010\u201029"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)61168\u20100"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12076"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1159\/000367625"},{"key":"e_1_2_9_29_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100034\u20101366692"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-018-4585-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-018-4585-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-018-4585-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-018-4585-y","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T23:28:26Z","timestamp":1704929306000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-018-4585-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,14]]},"references-count":28,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1007\/s00268-018-4585-y"],"URL":"https:\/\/doi.org\/10.1007\/s00268-018-4585-y","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,14]]},"assertion":[{"value":"14 March 2018","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"All the authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}