{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T23:56:19Z","timestamp":1783727779216,"version":"3.55.0"},"reference-count":10,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The optimal surgical approach for complicated diverticulitis in the emergency setting remains controversial. This retrospective cohort study aimed to investigate the clinical outcomes associated with Hartmann\u2019s procedure (HP) and primary anastomosis (with and without ileostomy) in patients diagnosed with complicated diverticulitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data were collected from the American College of Surgeons\u2014National Surgical Quality Improvement Program participant user files from 2016 to 2021. A total of 25,458 patients with acute diverticulitis and emergency surgery were included. The patients were categorized into three groups: those who underwent HP, those who underwent primary anastomosis with ileostomy and those who underwent primary anastomosis without ileostomy. The primary outcomes assessed were medical-related morbidity and anastomotic leak. Secondary outcomes included mortality, unplanned readmission, and length of in-hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Compared to patients who underwent the primary anastomosis procedure, the HP group displayed significantly higher rates of medical-related morbidity, and higher mortality rates, even after multivariate adjustment and propensity score analysis. Patients who received the ileostomy exhibited a statistically significantly higher medical-related morbidity and unplanned readmission rates. However, aside from these outcomes, the two groups did not exhibit significantly different rates in any of the other outcomes studied, including anastomotic leak. In patients with septic shock, primary anastomosis without diverting loop ileostomy was associated with significantly lower unplanned readmission when compared with the ileostomy group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Primary anastomosis demonstrated superior outcomes when compared with HP, and there are potential benefits of avoiding a diverting loop ileostomy. Hemodynamical status was not associated with worse prognosis in the primary anastomosis group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429251370996","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T18:27:57Z","timestamp":1757960877000},"page":"721-725","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing the Optimal Surgical Approach for Complicated Diverticulitis in the Emergency Setting: Results from a Cohort Study Using National Surgical Quality Improvement Program Database"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5998-7925","authenticated-orcid":false,"given":"Rodrigo Moises","family":"de Almeida Leite","sequence":"first","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."},{"name":"Department of Colon &amp; Rectal Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joh","family":"Hama","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Monforte","family":"Toledo","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Sarah","family":"Portilho","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas de Araujo","family":"Horcel","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Vaz","family":"Pandini","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Cata Preta","family":"Stolzemburg","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Soares","family":"Gerbasi","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6695-0496","authenticated-orcid":false,"given":"Francisco","family":"Tustumi","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Edmond","family":"Seid","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio Eduardo Alonso","family":"Araujo","sequence":"additional","affiliation":[{"name":"Department of Colon &amp; Rectal Surgery, Hospital Israelita Albert Einstein, Sao Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"issue":"5","key":"e_1_3_4_2_2","first-page":"713","article-title":"Primary anastomosis versus Hartmann\u2019s procedure for perforated diverticulitis with peritonitis: An updated systematic review and meta-analysis","volume":"35","author":"Binda GA","year":"2020","unstructured":"Binda GA, , Serventi A, , Bonazza S, et al. Primary anastomosis versus Hartmann\u2019s procedure for perforated diverticulitis with peritonitis: An updated systematic review and meta-analysis. Int J Colorectal Dis, 2020; 35(5):713\u2013722; doi: 10.1007\/s00384-019-03499-x","journal-title":"Int J Colorectal Dis"},{"key":"e_1_3_4_3_2","first-page":"148","article-title":"Emergency surgery for complicated acute diverticulitis: Hartmann\u2019s procedure vs primary anastomosis","volume":"267","author":"Shaban Y","year":"2021","unstructured":"Shaban Y, , Elhassan A, , Binu R, et al. Emergency surgery for complicated acute diverticulitis: Hartmann\u2019s procedure vs primary anastomosis. J Surg Res, 2021; 267:148\u2013157; doi: 10.1016\/j.jss.2021.05.011","journal-title":"J Surg Res"},{"issue":"5","key":"e_1_3_4_4_2","first-page":"928","article-title":"Laparoscopic primary anastomosis versus Hartmann\u2019s procedure for perforated diverticulitis with purulent or fecal peritonitis: A systematic review and meta-analysis","volume":"86","author":"Cirocchi R","year":"2019","unstructured":"Cirocchi R, , Di Saverio S, , Weber DG, et al. Laparoscopic primary anastomosis versus Hartmann\u2019s procedure for perforated diverticulitis with purulent or fecal peritonitis: A systematic review and meta-analysis. J Trauma Acute Care Surg, 2019; 86(5):928\u2013938; doi: 10.1097\/TA.0000000000002173","journal-title":"J Trauma Acute Care Surg"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2017.09.004"},{"issue":"6","key":"e_1_3_4_6_2","first-page":"688","article-title":"Comparative outcome of Hartmann\u2019s procedure vs primary anastomosis with diverting ileostomy for perforated diverticulitis: A Multicenter Study","volume":"55","author":"Kulu Y","year":"2012","unstructured":"Kulu Y, , Tarantino I, , Bruckner T, et al. Comparative outcome of Hartmann\u2019s procedure vs primary anastomosis with diverting ileostomy for perforated diverticulitis: A Multicenter Study. Dis Colon Rectum, 2012; 55(6):688\u2013695; doi: 10.1097\/DCR.0b013e31824db58c","journal-title":"Dis Colon Rectum"},{"key":"e_1_3_4_7_2","unstructured":"American College of Surgeons. National Surgical Quality Improvement Program: Participant Use Data File. ACS NSQIP; Published 2021. Accessed [date]. Available from: https:\/\/www.facs.org\/quality-programs\/data-and-registries\/acs-nsqip"},{"issue":"4","key":"e_1_3_4_8_2","first-page":"827","article-title":"A nationwide study evaluating short-term outcomes after laparoscopic and open sigmoid resection for diverticulitis","volume":"257","author":"Kolfschoten NE","year":"2013","unstructured":"Kolfschoten NE, , Marijnen CAM, , Bemelman WA, et al. A nationwide study evaluating short-term outcomes after laparoscopic and open sigmoid resection for diverticulitis. Ann Surg, 2013; 257(4):827\u2013833; doi: 10.1097\/SLA.0b013e318285b687","journal-title":"Ann Surg"},{"issue":"4","key":"e_1_3_4_9_2","first-page":"431","article-title":"Predictors for rectal stump leakage after Hartmann\u2019s procedure for perforated diverticulitis","volume":"33","author":"Schmelzle M","year":"2018","unstructured":"Schmelzle M, , Alhussein M, , Rahmanian PB, et al. Predictors for rectal stump leakage after Hartmann\u2019s procedure for perforated diverticulitis. Int J Colorectal Dis, 2018; 33(4):431\u2013437; doi: 10.1007\/s00384-018-3012-x","journal-title":"Int J Colorectal Dis"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-013-1044-5"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-017-2872-y"}],"container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10926429251370996","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429251370996","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429251370996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T05:27:43Z","timestamp":1779773263000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10926429251370996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,21]]},"references-count":10,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9,1]]}},"alternative-id":["10.1177\/10926429251370996"],"URL":"https:\/\/doi.org\/10.1177\/10926429251370996","relation":{},"ISSN":["1092-6429","1557-9034"],"issn-type":[{"value":"1092-6429","type":"print"},{"value":"1557-9034","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,21]]}}}