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Long-term Outcomes of Laparoscopic Lavage for Perforated Diverticulitis Remain Unfavorable—Reply | JAMA Surgery | ÌÇÐÄvlog

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Comment & Response
July 28, 2021

Long-term Outcomes of Laparoscopic Lavage for Perforated Diverticulitis Remain Unfavorable—Reply

Author Affiliations
  • 1Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
  • 2Department of Surgery, SkÃ¥ne University Hospital, Malmö, Sweden
  • 3Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
JAMA Surg. 2021;156(11):1071. doi:10.1001/jamasurg.2021.3306

In Reply We would like to thank Acuna and colleagues for their Letter to the Editor with a thorough analysis of our recently published article,1 which directed our attention to the reported severe complication rate. Our article correctly stated that there was no significant difference in severe complications between the groups at long-term follow-up; however, unfortunately there was an error in the count of complications (Table 2 and in the Results section1). We have taken the appropriate measures to correct this mistake.2 The conclusions of the study are unaltered.

It is correct that the observed nonsignificant difference in severe complications between laparoscopic lavage and resection had almost disappeared at 5-year follow-up (corrected count: 21 [29%] vs 17 [25%], respectively; P = .58). However, this was evident at 1-year follow-up (27% vs 21%; P = .45) and was mainly due to laparotomy-related complications in the resection group (wound dehiscence and hernia surgery).3 The observed nonsignificant difference in all-cause mortality might be a result of the slight age difference between the groups. Unfortunately, few patients in Norway and Sweden are autopsied. Cause of death records are consequently unreliable, which is why only all-cause mortality was reported.1 The cause of death was unavailable in 9 patients and recorded disease-related mortality was 6 of 23 (26%) in the laparoscopic lavage and 4 of 17 (24%) in the resection group, respectively (P = .85).

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