BACKGROUND: The benefits of laparoscopic (LC) versus open (OC) colectomy for symptomatic colonic diverticulosis as an elective operation remain unclear. METHODS: Using the American College of Surgeons-National Surgical Quality Improvement Project (ACS-NSQIP) participant-user file, patients were identified who underwent elective colon resection for symptomatic colonic diverticulosis, between 2005 and 2008. Demographic, clinical, intraoperative variables, and 30-day morbidity and mortality were collected. Logistic regression analysis was performed to determine the association between the surgical approach (LC vs. OC) and risk-adjusted overall mortality, overall morbidity, serious morbidity, and wound complications. RESULTS: A total of 7,629 patients were identified who underwent colon resection for symptomatic diverticulosis. They were subdivided into two groups: OC (3,870 (50.7%)) and LC (3,759 (49.3%)). Patients who underwent OC were significantly older (59.0 vs. 55.7 years, P < 0.0001) with more comorbidities compared with those who underwent LC. After risk-adjusted analysis, it was noted that the patients treated with LC were significantly less likely to experience overall morbidity (11.9% vs. 23.2%), serious morbidity (4.6% vs. 10.9%), and wound complications (9.1% vs. 17.5%), but not mortality (0.3% vs. 0.8%). Operative duration was significantly longer with LC (176.64 vs. 166.70 min, P < 0.0001), but the length of stay was significantly shorter (4.77 vs. 7.68 days, P < 0.0001). Using logistic regression analysis, patients with history of peripheral vascular disease, percutaneous coronary interventions, current steroid use, and hypertension requiring medication were at an increased risk of morbidity and mortality at 30 days. Patients with history of chronic obstructive pulmonary disease and smoking experienced more wound complications at 30 days. CONCLUSIONS: In the elective setting for symptomatic diverticulosis, LC seems to be associated with lower 30-day morbidity and complication rates compared with OC.
BACKGROUND: The benefits of laparoscopic (LC) versus open (OC) colectomy for symptomatic colonic diverticulosis as an elective operation remain unclear. METHODS: Using the American College of Surgeons-National Surgical Quality Improvement Project (ACS-NSQIP) participant-user file, patients were identified who underwent elective colon resection for symptomatic colonic diverticulosis, between 2005 and 2008. Demographic, clinical, intraoperative variables, and 30-day morbidity and mortality were collected. Logistic regression analysis was performed to determine the association between the surgical approach (LC vs. OC) and risk-adjusted overall mortality, overall morbidity, serious morbidity, and wound complications. RESULTS: A total of 7,629 patients were identified who underwent colon resection for symptomatic diverticulosis. They were subdivided into two groups: OC (3,870 (50.7%)) and LC (3,759 (49.3%)). Patients who underwent OC were significantly older (59.0 vs. 55.7 years, P < 0.0001) with more comorbidities compared with those who underwent LC. After risk-adjusted analysis, it was noted that the patients treated with LC were significantly less likely to experience overall morbidity (11.9% vs. 23.2%), serious morbidity (4.6% vs. 10.9%), and wound complications (9.1% vs. 17.5%), but not mortality (0.3% vs. 0.8%). Operative duration was significantly longer with LC (176.64 vs. 166.70 min, P < 0.0001), but the length of stay was significantly shorter (4.77 vs. 7.68 days, P < 0.0001). Using logistic regression analysis, patients with history of peripheral vascular disease, percutaneous coronary interventions, current steroid use, and hypertension requiring medication were at an increased risk of morbidity and mortality at 30 days. Patients with history of chronic obstructive pulmonary disease and smoking experienced more wound complications at 30 days. CONCLUSIONS: In the elective setting for symptomatic diverticulosis, LC seems to be associated with lower 30-day morbidity and complication rates compared with OC.
Authors: Muhammed R S Siddiqui; Muhammed S Sajid; Kamran Khatri; Elizabeth Cheek; Mirza K Baig Journal: World J Surg Date: 2010-12 Impact factor: 3.352
Authors: H D Vargas; R T Ramirez; G C Hoffman; G W Hubbard; R J Gould; S D Wohlgemuth; W K Ruffin; J E Hatter; P Kolm Journal: Dis Colon Rectum Date: 2000-12 Impact factor: 4.585
Authors: Hossein Masoomi; Brian Buchberg; Brian Nguyen; Vicrumdeep Tung; Michael J Stamos; Steven Mills Journal: World J Surg Date: 2011-09 Impact factor: 3.352
Authors: H H Chen; S D Wexner; E G Weiss; J J Nogueras; O Alabaz; A J Iroatulam; A Nessim; J S Joo Journal: Surg Endosc Date: 1998-12 Impact factor: 4.584
Authors: Gabriela Batista Rodríguez; Andrea Balla; Santiago Corradetti; Carmen Martinez; Pilar Hernández; Jesús Bollo; Eduard M Targarona Journal: Int J Colorectal Dis Date: 2018-04-06 Impact factor: 2.571
Authors: Jörn-Markus Gass; Diana Daume; Fiorenzo Angehrn; Martin Bolli; Romano Schneider; Daniel Steinemann; Francesco Mongelli; Andreas Scheiwiller; Lana Fourie; Beatrice Kern; Markus von Flüe; Jürg Metzger Journal: Surg Endosc Date: 2022-01-13 Impact factor: 3.453
Authors: Michael J Diamant; Samuel Schaffer; Stephanie Coward; M Ellen Kuenzig; James Hubbard; Bertus Eksteen; Steven Heitman; Remo Panaccione; Subrata Ghosh; Gilaad G Kaplan Journal: PLoS One Date: 2016-07-28 Impact factor: 3.240