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PeritonitisDIVERTI2NCT04604730

Role of Protective Stoma After Primary Anastomosis for Generalized Peritonitis Due to Perforated Diverticulitis

A study testing Primary anastomosis without protective stoma and Anastomosis with protective stoma in people with Peritonitis, run by University Hospital, Rouen at 20 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This study is designed to be a multicentre, prospective, comparative, randomised trial, evaluating the efficacy of two surgical strategies for the treatment of generalised peritonitis due to perforated diverticulitis. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Peritonitis
What is being tested?
Primary anastomosis without protective stoma and Anastomosis with protective stoma
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
204 participants
Where
20 sitesFrance
Study dates
11 Jun 2021to 1 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years
  • Patients operated for purulent or fecal peritonitis (Hinchey grade III and IV) secondary to perforated diverticulitis of the left colon and treated by resection with primary anastomosis
  • Person informed and having signed his consent. If the patient is unable to sign his consent, the consent will be signed by his representative ((1) the trusted person, or failing that, (2) a family member, or (3) a relative of the person concerned) (Article L1122-1-1 of the CSP). In this case, consent to continue the study will subsequently be requested from the patient. --> In addition, due to the vital urgency represented by hospitalisation in intensive care for purulent or fecal peritonitis, inclusion without prior collection of the consent of the patient or his/her representative is possible in the case where the patient is not capable of giving consent and his/her representative is not present at the time of inclusion (Article L1122-1-3 of the CSP). In this case, the patient or his/her representative will be informed as soon as possible and his/her written consent will be requested for the possible continuation of this research and the use of the data concerning him/her.
  • Patient able to comply with the study protocol, in the investigator's judgment
  • Patient affiliated with, or beneficiary of a social security (health insurance) category
  • Non-inclusion Criteria:
Show all 16Show fewer
  • Physical states that prevent patient participation (e.g. septic shock or multivisceral failure)
  • Steroid treatment > 20 mg daily
  • Prior pelvic irradiation
  • Immunocompromised status
  • Known progressive cancer
  • American Society of Anesthesiologists grade IV
  • Peritonitis secondary to perforated diverticulitis of the right colon
  • Patient is a pregnant (positive blood pregnancy test) or breastfeeding (lactating) woman or intending to become pregnant during the study
  • Person deprived of liberty by administrative or judicial decision or placed under judicial protection (guardianship or supervision)
  • Simultaneous participation in another interventional research

Who cannot join

  • 1. Failure to obtain the consent of the patient or the patient's representative

Trial locations and contacts

20 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Valérie BRIDOUX, Pr contact

02 32 88 81 42

valerie.bridoux@chu-rouen.fr

20 sites in 1 country

France20 sites, 20 recruiting
  • CHU Amiens

    Amiens

    Jean-Marc REGIMBEAU

    Jean-Marc REGIMBEAU

    Recruiting
  • CHR Beauvais

    Beauvais, Beauvais, 60021

    Francois MAUVAIS, MD, +33 344 11 ext. 2626, f.mauvais@ch-beauvais.fr

    Not yet recruiting
  • CH Beauvais

    Beauvais

    François MAUVAIS

    François MAUVAIS

    Not yet recruiting
  • CHU Besançon

    Besançon

    Zaher LAKKIS

    Zaher LAKKIS

    Not yet recruiting
  • APHP Avicenne

    Bobigny

    Christophe TRESALLET

    Christophe TRESALLET

    Not yet recruiting
  • CHU Brest

    Brest

    Bogdan BADIC

    Bogdan BADIC

    Recruiting
  • CHU Caen

    Caen

    Arnaud ALVES

    Arnaud ALVES

    Not yet recruiting
  • CHU Clermont Ferrand

    Clermont-Ferrand

    Anne DUBOIS

    Anne DUBOIS

    Not yet recruiting
  • APHP Henri Mondor

    Créteil

    Nicolas DE'ANGELIS

    Nicolas DE'ANGELIS

    Not yet recruiting
  • CHU Grenoble

    Grenoble

    Jean-Luc FAUCHERON

    Jean-Luc FAUCHERON

    Not yet recruiting
  • CHU Limoges

    Limoges

    Muriel MATHONNET

    Muriel MATHONNET

    Not yet recruiting
  • CHU Lyon

    Lyon

    Eddy COTTE

    Eddy COTTE

    Not yet recruiting
  • APHM Hôpital Nord

    Marseille

    Laura BEYER BERJOT

    Laura BEYER BERJOT

    Recruiting
  • APHM La Timone

    Marseille

    Diane MEGE

    Diane MEGE

    Recruiting
  • CHU Nancy

    Nancy

    Adeline GERMAIN

    Adeline GERMAIN

    Not yet recruiting
  • CHU Nantes

    Nantes

    Guillaume MEURETTE

    Guillaume MEURETTE

    Not yet recruiting
  • CHU Nimes

    Nîmes

    Michel PRUDHOMME

    Michel PRUDHOMME

    Not yet recruiting
  • APHP St Antoine

    Paris

    Yann PARC

    Yann PARC

    Not yet recruiting
  • CHU Rouen

    Rouen

    Valérie BRIDOUX

    Valérie BRIDOUX

    Recruiting
  • CHU Tours

    Tours

    Mehdi OUAISSI

    Mehdi OUAISSI

    Recruiting

Other trials in France

About this study

Official title: Role of Protective Stoma After Primary Anastomosis for Generalized Peritonitis Due to Perforated Diverticulitis: a Prospective Multicenter Randomized Trial

This study is designed to be a multicentre, prospective, comparative, randomised trial, evaluating the efficacy of two surgical strategies for the treatment of generalised peritonitis due to perforated diverticulitis. Results will be analysed according to an intention to treat principle (after selection and patient consent). Immediately before surgery, the patient will be randomly assigned to sigmoidectomy with primary anastomosis or to sigmoidectomy with primary anastomosis and diverting stoma. Sigmoidectomy will be performed through a midline laparotomy or laparoscopically according to the standard technique. In the control arm, a protective stoma will be performed at the end of surgery. A stoma reversal operation will be performed at least 3 months after the first operation and after performing a cologram by water soluble contrast between 4 and 8 weeks to check for the absence of fistula or stenosis at the level of the anastomosis. Stoma reversal will be performed with a trephine incision.

Post-stoma closure follow-ups will be planned and all morbidity/mortality will be recorded. All patients will be examined at 6, 12, and 24 weeks after the initial surgery, in the surgical department where they were operated; a final study visit will be carried out 12 months (evaluation of primary endpoint) after surgery. The parameters explored at medical examinations will be: • Occurrence of complications • Quality of life assessment

Read the detailed description

This study is designed to be a multicentre, prospective, comparative, randomised trial, evaluating the efficacy of two surgical strategies for the treatment of generalised peritonitis due to perforated diverticulitis. Results will be analysed according to an intention to treat principle. The diagnosis will be established by the surgeon investigator on clinical data, imagery and operative findings during a laparotomy or laparoscopy. After selection and patient consent and immediately before surgery, the patient will be randomly assigned to sigmoidectomy with primary anastomosis or to sigmoidectomy with primary anastomosis and diverting stoma. Sigmoidectomy will be performed through a midline laparotomy or laparoscopically according to the standard technique, with lateral to medial mobilisation of the left colon, mobilisation of splenic flexure and identification of left ureter. The rectosigmoid junction will be exposed and transected with a stapler. Proximal section will be performed on a healthy colonic segment. The anastomosis will be performed according to the surgeon investigator's preference (mechanical or manual anastomosis; end to end or side to end).

Decisions to clean the colon intraoperatively and to place a drain will be left to the surgeon's discretion. In the control arm, a protective stoma will be performed at the end of surgery. A stoma reversal operation will be performed at least 3 months after the first operation and after performing a cologram by water soluble contrast between 4 and 8 weeks to check for the absence of fistula or stenosis at the level of the anastomosis. Stoma reversal will be performed with a trephine incision.

Post-stoma closure follow-ups will be planned and all morbidity/mortality will be recorded. All patients will be examined at 6, 12, and 24 weeks after the initial surgery, in the surgical department where they were operated; a final study visit will be carried out 12 months (evaluation of primary endpoint) after surgery. The parameters explored at medical examinations will be: • Occurrence of complications • Quality of life assessment

Conditions
Peritonitis
Being tested
Primary anastomosis without protective stoma, Anastomosis with protective stoma
Keywords
peritonitis, perforated diverticulitis, primary anastomosis, protective stoma
Medical subject headings
Peritonitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Primary anastomosis without protective stomaProcedure or surgery

    Primary anastomosis without protective stoma

  • Anastomosis with protective stomaProcedure or surgery

    Anastomosis with protective stoma

Study groups in NCT04604730
Study groupRoleWhat they receive
Primary anastomosis without protective stomaExperimentalPrimary anastomosis without protective stoma
Receives: Procedure: Primary anastomosis without protective stoma
Anastomosis with protective stomaActive comparatorAnastomosis with protective stoma
Receives: Procedure: Anastomosis with protective stoma

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Comparison of overall morbidity between "with protective stoma" and "without protective stoma"

    Overall morbidity graded 0 to 5 according to the Clavien-Dindo classification All complications occurring during hospitalization will be collected. Late complications occurring after hospitalization will be collected during follow-up.

    Measured: 12 months posteoperatively

Secondary outcomes (14)
  1. Comparison of the rate of death between "with protective stoma" and "without protective stoma"

    rate of death at 3 months after surgery (%)

    Measured: 3 months postoperatively

  2. Comparison of the rate of reinterventions between "with protective stoma" and "without protective stoma"

    the rate of reinterventions after the surgery (%)

    Measured: 12 months postoperatively

  3. Comparison of the rate of incisional surgical site infection (SSI) between "with protective stoma" and "without protective stoma"

    the rate of incisional SSI (%)

    Measured: 12 months postoperatively

  4. Comparison of the rate of organ/space SSI between "with protective stoma" and "without protective stoma"

    the rate of organ/space SSI (%)

    Measured: 12 months postoperatively

  5. Comparison of the rate of wound disruptions between "with protective stoma" and "without protective stoma"

    the rate of wound disruptions (%)

    Measured: 12 months postoperatively

  6. Comparison of the rate of anastomotic leaks between "with protective stoma" and "without protective stoma"

    the rate of anastomotic leaks (%)

    Measured: 12 months postoperatively

  7. Comparison of operating time between "with protective stoma" and "without protective stoma"

    time of surgery (hours)

    Measured: surgery

  8. Comparison of length of postoperative hospital stay between "with protective stoma" and "without protective stoma"

    Length of postoperative hospital stay (days)

    Measured: 6 months postoperatively

  9. Comparison of Intensive Care Unit (ICU) length of stay between "with protective stoma" and "without protective stoma"

    ICU length of stay (days)

    Measured: 6 months postoperatively

  10. Comparison of the number of patients alive without stoma between "with protective stoma" and "without protective stoma"

    Number of patients alive without stoma at 12 months after initial surgery

    Measured: 12 months after initial surgery

  11. Comparison of the quality of life between "with protective stoma" and "without protective stoma"

    Quality of life evaluated using the Short Form Health Survey (SF-36) questionnaire at baseline, 6, 12, 26 and 52 weeks after primary surgery Score from 1 to 30

    Measured: 6, 12, 26 and 52 weeks after primary surgery

  12. Comparison of the quality of life between "with protective stoma" and "without protective stoma" with "EuroQol-5 Dimensions" questionnaire

    Quality of life evaluated using EuroQol-5 Dimensions (EQ-5D) questionnaire at baseline, 6, 12, 26 and 52 weeks after primary surgery Each dimension has three levels of response: no problems (coded 1), some problems (coded 2) and major problems (coded 3), which defines 243 possible health states (35), to which can be added unconscious and dead states, for a total of 245 states. Thus, the health states range from "11111" (no problems on all dimensions) to "33333": major problems on all dimensions + visual analog scale from 0 to 100, 0 being the worst and 100 the best

    Measured: 6, 12, 26 and 52 weeks after primary surgery

  13. Comparison of the quality of life between "with protective stoma" and "without protective stoma" with the Gastrintestinal Quality of Life Index questionnaire

    Quality of life evaluated using Ethe Gastrintestinal Quality of Life Index questionnaire at baseline, 6, 12, 26 and 52 weeks after primary surgery Score from 0 to 144, the higher the score, the better the quality of life

    Measured: 6, 12, 26 and 52 weeks after primary surgery

  14. Comparison of the cost utility between "with protective stoma" and "without protective stoma"

    Quality-Adjusted Life Year (QALY) derived from the EQ5D-5L questionnaire

    Measured: 12 months after primary surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Oct 2020
  2. Study start11 Jun 2021
  3. Primary completion1 Sep 2026 (estimated)
  4. Study completion1 Dec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Sequential assignment
Masking
None (open label)
Enrolment
204 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04604730
Sponsor's protocol ID
2019/0409/HP
Other IDs
2020-A01538-31
Acronym
DIVERTI2
Status last verified
Sep 2025
First submitted
15 Oct 2020
Last updated
8 Jun 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Pinson J, Tuech JJ, Ouaissi M, Mathonnet M, Mauvais F, Houivet E, Lacroix E, Rondeaux J, Sabbagh C, Bridoux V. Role of protective stoma after primary anastomosis for generalized peritonitis due to perforated diverticulitis-DIVERTI 2 (a prospective multicenter randomized trial): rationale and design (nct04604730). BMC Surg. 2022 May 16;22(1):191. doi: 10.1186/s12893-022-01589-w.

    PubMed 35578267

Questions about this trial

What is this clinical trial studying?

A study testing Primary anastomosis without protective stoma and Anastomosis with protective stoma in people with Peritonitis, run by University Hospital, Rouen at 20 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 16 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 8 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Valérie BRIDOUX, Pr (02 32 88 81 42, valerie.bridoux@chu-rouen.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Comparison of overall morbidity between "with protective stoma" and "without protective stoma" (time frame: 12 months posteoperatively). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04604730, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jun 2026.

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