BACKGROUND: Early studies comparing laparoscopic and open operations for diverticulitis failed to show any advantages of the laparoscopic approach. Our study compared the 30-day postoperative outcomes of laparoscopic and open sigmoid colectomy for diverticulitis by surgeons who had performed 20 or more laparoscopic colectomies before the study period. HYPOTHESIS: Patients who undergo an elective laparoscopic operation for diverticulitis have reduced postoperative complications compared with patients who have a traditional open operation. DESIGN: Retrospective analysis. SETTING: Academic medical center. PATIENTS: A total of 249 patients who underwent elective open (n = 127) or laparoscopic (n = 122) sigmoid colectomy with primary anastomosis for diverticulitis between July 1, 2001, and February 1, 2008. MAIN OUTCOME MEASURES: Combined rates of free and contained anastomotic leaks. A logistic regression model was used to determine predictors of anastomotic leaks while controlling for significant differences between study groups. RESULTS: Patients who underwent laparoscopic or open operations were similar in age, sex, history of diagnosed intraabdominal abscess (9.4% vs 12.3%), and history of preoperative percutaneous abscess drainage (3.9% vs 4.9%). Patients who underwent the open procedure had a higher Charlson comorbidity index (1.6 vs 1.2; P = .04), and those who underwent laparoscopy more frequently underwent splenic flexure mobilization (82.8% vs 26.7%; P < .001). Patients who underwent a laparoscopy had lower rates of anastomotic leaks (2.4% vs 8.2%; P = .04). This finding held true on logistic regression analysis (odds ratio, 0.67; 95% confidence interval, 0.008-0.567; P = .01), even when controlling for age, Charlson comorbidity index, splenic flexure mobilization, and length of resected bowel. CONCLUSION: Anastomotic leaks occurred less frequently after laparoscopic sigmoid colectomy performed by experienced laparoscopic colorectal surgeons.
BACKGROUND: Early studies comparing laparoscopic and open operations for diverticulitis failed to show any advantages of the laparoscopic approach. Our study compared the 30-day postoperative outcomes of laparoscopic and open sigmoid colectomy for diverticulitis by surgeons who had performed 20 or more laparoscopic colectomies before the study period. HYPOTHESIS: Patients who undergo an elective laparoscopic operation for diverticulitis have reduced postoperative complications compared with patients who have a traditional open operation. DESIGN: Retrospective analysis. SETTING: Academic medical center. PATIENTS: A total of 249 patients who underwent elective open (n = 127) or laparoscopic (n = 122) sigmoid colectomy with primary anastomosis for diverticulitis between July 1, 2001, and February 1, 2008. MAIN OUTCOME MEASURES: Combined rates of free and contained anastomotic leaks. A logistic regression model was used to determine predictors of anastomotic leaks while controlling for significant differences between study groups. RESULTS:Patients who underwent laparoscopic or open operations were similar in age, sex, history of diagnosed intraabdominal abscess (9.4% vs 12.3%), and history of preoperative percutaneous abscess drainage (3.9% vs 4.9%). Patients who underwent the open procedure had a higher Charlson comorbidity index (1.6 vs 1.2; P = .04), and those who underwent laparoscopy more frequently underwent splenic flexure mobilization (82.8% vs 26.7%; P < .001). Patients who underwent a laparoscopy had lower rates of anastomotic leaks (2.4% vs 8.2%; P = .04). This finding held true on logistic regression analysis (odds ratio, 0.67; 95% confidence interval, 0.008-0.567; P = .01), even when controlling for age, Charlson comorbidity index, splenic flexure mobilization, and length of resected bowel. CONCLUSION:Anastomotic leaks occurred less frequently after laparoscopic sigmoid colectomy performed by experienced laparoscopic colorectal surgeons.
Authors: Niels Komen; Juliette Slieker; Paul Willemsen; Guido Mannaerts; Piet Pattyn; Tom Karsten; Hans de Wilt; Erwin van der Harst; Willem van Leeuwen; Christine Decaestecker; Hans Jeekel; Johan F Lange Journal: Int J Colorectal Dis Date: 2014-01 Impact factor: 2.571
Authors: Luigi De Magistris; Juan Santiago Azagra; Martine Goergen; Vito De Blasi; Luca Arru; Olivier Facy Journal: Surg Endosc Date: 2013-02-23 Impact factor: 4.584
Authors: Joseph C Carmichael; Deborah S Keller; Gabriele Baldini; Liliana Bordeianou; Eric Weiss; Lawrence Lee; Marylise Boutros; James McClane; Scott R Steele; Liane S Feldman Journal: Surg Endosc Date: 2017-08-03 Impact factor: 4.584
Authors: Ryan S Turley; Andrew S Barbas; Michael E Lidsky; Christopher R Mantyh; John Migaly; John E Scarborough Journal: Dis Colon Rectum Date: 2013-01 Impact factor: 4.585