{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:30:25Z","timestamp":1789655425356,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:00:00Z","timestamp":1584403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this meta\u2010analysis was to comparatively evaluate the outcomes of primary anastomosis (PRA) and nonrestorative resection (NRR) as emergency surgery and ostomy reversal in patients with perforated diverticulitis and peritonitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, MEDLINE via Ovid, Embase, CINAHL, Cochrane Library and Web of Science databases were systematically searched. Postoperative morbidity following emergency resection was the primary end\u2010point. Quality assessment of the included studies was performed using the Cochrane Quality Assessment Tool including recruitment bias and crossover with intention\u2010to\u2010treat analysis. The Haenszel\u2013Mantel method with odds ratios (OR, 95% CI) and the inverse variance method with mean difference (MD, 95% CI) as effect measures were utilized for dichotomous and continuous outcomes, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four randomized controlled trials totaling 382 patients (180 PRA <jats:italic>vs<\/jats:italic> 204 NRR) were included. Morbidity rates following emergency resection did not differ (OR =\u00a00.99, 95% CI\u00a00.65, 1.51; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.95; number needed to treat\/harm (NNT) 96). Organ\/space surgical site infection rates were 3.3% in PRA <jats:italic>vs<\/jats:italic> 11.3% in NRR (OR =\u00a00.29, 95% CI\u00a00.12, 0.74; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009; NNT\u00a0=\u00a013). Postoperative morbidity rates following ostomy reversal were significantly lower in PRA (OR =\u00a00.31, 95% CI 0.15, 0.64; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001; NNT\u00a0=\u00a07). Pooled ostomy non\u2010reversal rates were 16% in PRA <jats:italic>vs<\/jats:italic> 35.5% in NRR (OR =\u00a00.37, 95% CI\u00a00.22, 0.62; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0001; NNT\u00a0=\u00a06) with high heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a063%; <jats:italic>\u03c4<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a08.17). Meta\u2010regression analysis revealed significant negative correlation between the PRA\u2010to\u2010NRR crossover rate and the ostomy non\u2010reversal rate (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.029).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis found that PRA was associated with better short\u2010 and long\u2010term outcomes at the cost of significantly longer operating time at emergency surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15016","type":"journal-article","created":{"date-parts":[[2020,2,15]],"date-time":"2020-02-15T04:26:26Z","timestamp":1581740786000},"page":"1245-1257","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Primary anastomosis and nonrestorative resection for perforated diverticulitis with peritonitis: meta\u2010analysis of randomized trials"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9200-1304","authenticated-orcid":false,"given":"M.","family":"Gachabayov","sequence":"first","affiliation":[{"name":"Section of Colorectal Surgery Department of Surgery Westchester Medical Center New York Medical College Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. J.","family":"Tuech","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Rouen University Hospital Rouen Cedex France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6404-389X","authenticated-orcid":false,"given":"I.","family":"Tulina","sequence":"additional","affiliation":[{"name":"Department of Surgery Sechenov Moscow Medical University Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Coget","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Rouen University Hospital Rouen Cedex France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Bridoux","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Rouen University Hospital Rouen Cedex 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