Can laparoscopically assisted sigmoid resection provide uncomplicated management even in cases of complicated diverticulitis? View Full Text


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Article Info

DATE

2006-07

AUTHORS

C. Reissfelder, H. J. Buhr, J.-P. Ritz

ABSTRACT

BACKGROUND: Laparoscopically assisted sigmoid resection has become an accepted method for treating uncomplicated diverticulitis. This prospective study aimed to compare the results of laparoscopic sigmoid resection for uncomplicated and complicated sigmoid diverticular disease used to check the indication for the complicated stages of diverticulitis. METHODS: All patients who underwent laparoscopic resection for sigmoid diverticulitis at the authors' hospital between 1999 and 2005 were divided into two groups: group 1 (uncomplicated diverticular disease) and group 2 (complicated diverticular disease). The exclusion criteria specified generalized peritonitis, signs of sepsis, and extensive previous abdominal surgery. RESULTS: Of the 203 patients (108 men and 95 women) who underwent laparoscopically assisted resection during the examination period, 112 were assigned to group 1 and 91 to group 2. Differences in favor of group 1 were found for the duration of surgery (154 vs 166 min), the conversion rate (1.8% vs 9.9%), the postoperative wound infections (2.7% vs 13.2%), and the postoperative hospitalization period (12.3 +/- 3.9 vs 15.0 +/- 5.6 days). No significant differences were seen in any other areas such as completion of nutritional buildup (4.6 vs 5.0 days) or time until the first postoperative bowel movement (2.8 vs 3.3 days). Total postoperative morbidity (16.1% vs 26.4%; p = 0.10) tended to be increased in group 2, but this difference was not statistically significant. CONCLUSIONS: Laparoscopic sigmoid resection can be performed for patients who have complicated diverticulitis without significantly increasing their overall morbidity. This group of patients could benefit from the advantages of the minimally invasive procedure despite a longer operating time and a higher conversion rate. More... »

PAGES

1055-1059

References to SciGraph publications

  • 1999-08. Laparoscopic-assisted colectomy for diverticular sigmoiditis in SURGICAL ENDOSCOPY
  • 1997-10. Is laparoscopic surgery applicable to complicated colonic diverticular disease? in SURGICAL ENDOSCOPY
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  • 1998-12. Elective laparoscopic-assisted colectomy for diverticular disease in SURGICAL ENDOSCOPY
  • 2000-03. Practice parameters for the treatment of sigmoid diverticulitis—Supporting documentation in DISEASES OF THE COLON & RECTUM
  • 1999-06. Laparoscopic resection of sigmoid diverticulitis in SURGICAL ENDOSCOPY
  • 2004-04. Laparoscopic colectomy for recurrent and complicated diverticulitis: a prospective study of 396 patients in LANGENBECK'S ARCHIVES OF SURGERY
  • 1999-08. Endoscopic Surgery: What Has Passed the Test? in WORLD JOURNAL OF SURGERY
  • 2004-02. Laparoscopic vs open resection for the treatment of diverticular disease in SURGICAL ENDOSCOPY
  • 2002-07. Sigmadivertikulitis Operationsindikation und -zeitpunkt in DER CHIRURG
  • 2002-01. Laparoscopic left colon resection for diverticular disease in SURGICAL ENDOSCOPY
  • 2004-11. Complications in laparoscopic colorectal surgery: results of a multicentre trial in TECHNIQUES IN COLOPROCTOLOGY
  • 1998-08. Laparoskopische Sigmaresektion bei Diverticulitis in DER CHIRURG
  • 1999-04. Diagnosis and treatment of diverticular disease in SURGICAL ENDOSCOPY
  • 1999-02. The role of conversion in laparoscopic colorectal surgery in SURGICAL ENDOSCOPY
  • 2002-07. Long-Term Follow-Up After First Acute Episode of Sigmoid Diverticulitis: Is Surgery Mandatory? in DISEASES OF THE COLON & RECTUM
  • 2005-03. Laparoscopic colectomy for diverticulitis is not associated with increased morbidity when compared with non-diverticular disease in INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
  • 2001-02. Importance of conversion for results obtained with laparoscopic colorectal surgery in DISEASES OF THE COLON & RECTUM
  • 2000-12. Defining the role of laparoscopic-assisted sigmoid colectomy for diverticulitis in DISEASES OF THE COLON & RECTUM
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00464-005-0529-3

    DOI

    http://dx.doi.org/10.1007/s00464-005-0529-3

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/16736310


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    51 schema:description BACKGROUND: Laparoscopically assisted sigmoid resection has become an accepted method for treating uncomplicated diverticulitis. This prospective study aimed to compare the results of laparoscopic sigmoid resection for uncomplicated and complicated sigmoid diverticular disease used to check the indication for the complicated stages of diverticulitis. METHODS: All patients who underwent laparoscopic resection for sigmoid diverticulitis at the authors' hospital between 1999 and 2005 were divided into two groups: group 1 (uncomplicated diverticular disease) and group 2 (complicated diverticular disease). The exclusion criteria specified generalized peritonitis, signs of sepsis, and extensive previous abdominal surgery. RESULTS: Of the 203 patients (108 men and 95 women) who underwent laparoscopically assisted resection during the examination period, 112 were assigned to group 1 and 91 to group 2. Differences in favor of group 1 were found for the duration of surgery (154 vs 166 min), the conversion rate (1.8% vs 9.9%), the postoperative wound infections (2.7% vs 13.2%), and the postoperative hospitalization period (12.3 +/- 3.9 vs 15.0 +/- 5.6 days). No significant differences were seen in any other areas such as completion of nutritional buildup (4.6 vs 5.0 days) or time until the first postoperative bowel movement (2.8 vs 3.3 days). Total postoperative morbidity (16.1% vs 26.4%; p = 0.10) tended to be increased in group 2, but this difference was not statistically significant. CONCLUSIONS: Laparoscopic sigmoid resection can be performed for patients who have complicated diverticulitis without significantly increasing their overall morbidity. This group of patients could benefit from the advantages of the minimally invasive procedure despite a longer operating time and a higher conversion rate.
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