BACKGROUND: The aim of the present study was to analyze changes regarding the indications for and results of laparoscopic treatment of sigmoid diverticulitis. METHODS: The data were collected within the framework of an ongoing prospective multicenter study carried out by the Lapa roscopic Colorectal Surgery Study Group and were submitted to a statistical subgroup analysis. The institutions participating in the study were divided into three groups by experience (Group I, >100 procedures; Group II, 30-100 procedures; Group III, < 30 procedures). RESULTS: Among the 3,868 recruited patients, sigmoid diverticulitis (n = 1,545, 40 percent) was by far the most common indication for surgery, and sigmoid resection (n = 2,160, 55.9 percent) was by far the most common laparoscopic procedure. A total of 1,353 patients (87.6 percent) had uncomplicated diverticulitis, whereas 192 (12.4 percent) had a complicated form of diverticular disease (Hinchey I-IV, diverticular bleeding, fistula formation). Cases of complicated diverticulitis were significantly more frequently operated on at institutions with greater experience (Group I, 20.8 percent; Group II, 8.7 percent; Group III, 7.9 percent). Despite this fact, these institutions still had better intraoperative complication rates (Group I, 5.0 percent; Group II, 5.8 percent; Group III, 6.9 percent), conversion rates (Group I, 4.4 percent; Group II, 6.7 percent; Group III, 7.7 percent), and postoperative morbidity (Group I, 15.9 percent; Group II, 16.6 percent; Group III, 18.6 percent) and mortality (Group I, 0.2 percent; Group II, 0.5 percent; Group III, 0.4 percent) rates. CONCLUSION: An increase in experience is associated with an expansion of laparoscopic indications to include complicated forms of diverticulitis, with comparable ntraoperative and postoperative complication rates, operating time, and mortality rates.
BACKGROUND: The aim of the present study was to analyze changes regarding the indications for and results of laparoscopic treatment of sigmoid diverticulitis. METHODS: The data were collected within the framework of an ongoing prospective multicenter study carried out by the Lapa roscopic Colorectal Surgery Study Group and were submitted to a statistical subgroup analysis. The institutions participating in the study were divided into three groups by experience (Group I, >100 procedures; Group II, 30-100 procedures; Group III, < 30 procedures). RESULTS: Among the 3,868 recruited patients, sigmoid diverticulitis (n = 1,545, 40 percent) was by far the most common indication for surgery, and sigmoid resection (n = 2,160, 55.9 percent) was by far the most common laparoscopic procedure. A total of 1,353 patients (87.6 percent) had uncomplicated diverticulitis, whereas 192 (12.4 percent) had a complicated form of diverticular disease (Hinchey I-IV, diverticular bleeding, fistula formation). Cases of complicated diverticulitis were significantly more frequently operated on at institutions with greater experience (Group I, 20.8 percent; Group II, 8.7 percent; Group III, 7.9 percent). Despite this fact, these institutions still had better intraoperative complication rates (Group I, 5.0 percent; Group II, 5.8 percent; Group III, 6.9 percent), conversion rates (Group I, 4.4 percent; Group II, 6.7 percent; Group III, 7.7 percent), and postoperative morbidity (Group I, 15.9 percent; Group II, 16.6 percent; Group III, 18.6 percent) and mortality (Group I, 0.2 percent; Group II, 0.5 percent; Group III, 0.4 percent) rates. CONCLUSION: An increase in experience is associated with an expansion of laparoscopic indications to include complicated forms of diverticulitis, with comparable ntraoperative and postoperative complication rates, operating time, and mortality rates.
Authors: Avinash Bhakta; Marcel Tafen; Owen Glotzer; Jonathan Canete; A David Chismark; Brian T Valerian; Steven C Stain; Edward C Lee Journal: Surg Endosc Date: 2015-08-15 Impact factor: 4.584
Authors: Bastiaan R Klarenbeek; Roberto Bergamaschi; Alexander A F A Veenhof; Donald L van der Peet; Wim T van den Broek; Elly S M de Lange; Willem A Bemelman; Pieter Heres; Antonio M Lacy; Miguel A Cuesta Journal: Surg Endosc Date: 2010-09-25 Impact factor: 4.584
Authors: G A Manukyan; M Waseda; N Inaki; J R Torres Bermudez; I A Gacek; A Rudinski; G F Buess Journal: Surg Endosc Date: 2007-05-05 Impact factor: 4.584
Authors: W Schwenk; N Günther; P Wendling; M Schmid; W Probst; K Kipfmüller; B Rumstadt; M K Walz; R Engemann; T Junghans Journal: Int J Colorectal Dis Date: 2007-08-18 Impact factor: 2.571
Authors: Kelly A Garrett; Bradley J Champagne; Brian T Valerian; David Peterson; Edward C Lee Journal: Surg Endosc Date: 2008-03-18 Impact factor: 4.584