What is the Optimal Time of Surgical Intervention After an Acute Attack of Sigmoid Diverticulitis: Early or Late Elective Laparoscopic ... View Full Text


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Article Info

DATE

2006-12

AUTHORS

Christoph Reissfelder, Heinz J. Buhr, Joerg-P. Ritz

ABSTRACT

PURPOSE: This prospective study was designed to check the ideal time of surgical intervention by comparing the results of early elective laparoscopic sigmoid resection after an inflammatory attack with those of late elective resection during the inflammation-free interval. METHODS: A total of 210 patients (114 males) underwent laparoscopic resection for acute sigmoid diverticulitis between 1999 and 2005. They were prospectively divided into two groups: Group I with an early elective sigmoid resection (5-8 days after initial antibiotic treatment); Group II in the inflammation-free interval (4-6 weeks after initial hospitalization). RESULTS: There was no difference between the groups with regard to age (55.7 years), American Society of Anesthesiologists score (1.86), previous diseases, and extent of inflammation. After surgery, 156 patients (74.3 percent) were complication-free. There was a total of ten conversions (Group I, 9; Group II, 1; P<0.05). Minor complications developed in 42 patients (abdominal wall abscess=24, intestinal atony=6, hematoma=9, urinary tract infection=2). Eight patients in Group I (P<0.05) developed anastomotic leaks. None of the patients died. CONCLUSIONS: In the majority of patients, laparoscopic sigmoid resection in sigmoid diverticulitis can be performed without conversion. Patients who underwent surgery in the inflammation-free interval had a lower complication rate than those submitted to early elective resection. In our patient population, we were able to show that surgery in the inflammation-free interval significantly reduces postoperative morbidity. It is thus preferable for patients with sigmoid diverticulitis to receive initial antibiotic treatment and then undergo late elective laparoscopic sigmoid resection. More... »

PAGES

1842-1848

References to SciGraph publications

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  • 1999-06. Laparoscopic resection of sigmoid diverticulitis in SURGICAL ENDOSCOPY
  • 1998-08. Laparoskopische Sigmaresektion bei Diverticulitis in DER CHIRURG
  • 2000-03. Practice parameters for the treatment of sigmoid diverticulitis—Supporting documentation in DISEASES OF THE COLON & RECTUM
  • 1999. Prophylaktische Operation bei der Divertikelerkrankung des Kolons — Stufenkonzept durch exakte Stadieneinteilung in BILANZ ZUR JAHRTAUSENDWENDE
  • 1999-08. Endoscopic Surgery: What Has Passed the Test? in WORLD JOURNAL OF SURGERY
  • 2004-04. Laparoscopic colectomy for recurrent and complicated diverticulitis: a prospective study of 396 patients in LANGENBECK'S ARCHIVES OF SURGERY
  • 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
  • 1999-04. Diagnosis and treatment of diverticular disease in SURGICAL ENDOSCOPY
  • 2004-02. Laparoscopic vs open resection for the treatment of diverticular disease 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/s10350-006-0730-z

    DOI

    http://dx.doi.org/10.1007/s10350-006-0730-z

    DIMENSIONS

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