Health economic analysis of laparoscopic lavage versus Hartmann’s procedure for diverticulitis in the randomized DILALA trial. BJS 2016; 103: 1539-1547.
Published: 22nd August 2016
Authors: J. Gehrman, E. Angenete, I. Björholt, D. Bock, J. Rosenberg, E. Haglind et al.
Open surgery with resection and colostomy (Hartmann's procedure) has been the standard treatment for perforated diverticulitis with purulent peritonitis. In recent years laparoscopic lavage has emerged as an alternative, with potential benefits for patients with purulent peritonitis, Hinchey grade
Clinical effectiveness and resource use were derived from the
The study included 43 patients who underwent laparoscopic lavage and 40 who had Hartmann's procedure in Denmark and Sweden during 2010–2014. In base‐case A, the difference in mean cost per patient between laparoscopic lavage and Hartmann's procedure was €–8983 (95 per cent c.i. –16 232 to –1735). The mean(s.d.) costs per patient in base‐case B were €25 703(27 544) and €45 498(38 928) for laparoscopic lavage and Hartmann's procedure respectively, resulting in a difference of €–19 794 (95 per cent c.i. –34 657 to –4931). The results were robust as demonstrated in sensitivity analyses.
The significant cost reduction in this study, together with results of safety and efficacy from
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