Gunjan S Desai1, Rajvilas Narkhede2, Prasad Pande2, Bhushan Bhole3, Paresh Varty2, Hitesh Mehta2. 1. Department of Gastrointestinal Surgery, Lilavati Hospital and Research Center, A-791, Bandra Reclamation Road, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, 400 050, India. desaigunjan526@gmail.com. 2. Department of Gastrointestinal Surgery, Lilavati Hospital and Research Center, A-791, Bandra Reclamation Road, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, 400 050, India. 3. Department of Gastrointestinal Surgery, King Edward Memorial Hospital, Parel, Mumbai, 400 012, India.
Abstract
BACKGROUND: All operative procedures for simple or complicated diverticulitis, including primary resection and anastomosis (PRA) with or without a diverting stoma, Hartmann procedure (HP), or stoma reversal, whether done in an elective setting or as an emergency, can be performed laparoscopically. However, owing to low incidence of the disease and complexity of the procedure, there are very few studies on outcomes of laparoscopic surgery for sigmoid diverticulitis from India. AIM: The present study was undertaken to evaluate outcomes of laparoscopically treated patients of sigmoid diverticulitis. METHODS: Prospective observational study enrolled 37 patients with sigmoid diverticulitis managed laparoscopically from March 2015 to March 2017. Demographic, clinical, operative, postoperative, and complication data were entered into a patient proforma and analyzed. RESULTS: Eleven simple and 26 complicated diverticulitis patients were operated laparoscopically, 22 in emergency setting and 15 in elective setting. Only three patients required conversion to open surgery-two due to dense adhesions and one due to chronic obstructive pulmonary disease (COPD). No patients had ureteric or bowel injury. Eighteen patients underwent laparoscopic PRA without stoma, 11 patients had PRA with stoma, 6 had HP, and 2 had laparoscopic lavage. Results showed lesser blood loss, shorter hospital stay, and fewer complications in the elective group and simple diverticulitis patients. None of the patients had anastomosis-related complications. Two patients had stoma-related complications. CONCLUSION: Laparoscopic management of diverticulitis is feasible, safe, provides the benefits of less wound-related complications, and shorter hospital stay and should be the surgical procedure of choice in elective or emergency setting for simple/complicated diverticulitis.
BACKGROUND: All operative procedures for simple or complicated diverticulitis, including primary resection and anastomosis (PRA) with or without a diverting stoma, Hartmann procedure (HP), or stoma reversal, whether done in an elective setting or as an emergency, can be performed laparoscopically. However, owing to low incidence of the disease and complexity of the procedure, there are very few studies on outcomes of laparoscopic surgery for sigmoid diverticulitis from India. AIM: The present study was undertaken to evaluate outcomes of laparoscopically treated patients of sigmoid diverticulitis. METHODS: Prospective observational study enrolled 37 patients with sigmoid diverticulitis managed laparoscopically from March 2015 to March 2017. Demographic, clinical, operative, postoperative, and complication data were entered into a patient proforma and analyzed. RESULTS: Eleven simple and 26 complicated diverticulitispatients were operated laparoscopically, 22 in emergency setting and 15 in elective setting. Only three patients required conversion to open surgery-two due to dense adhesions and one due to chronic obstructive pulmonary disease (COPD). No patients had ureteric or bowel injury. Eighteen patients underwent laparoscopic PRA without stoma, 11 patients had PRA with stoma, 6 had HP, and 2 had laparoscopic lavage. Results showed lesser blood loss, shorter hospital stay, and fewer complications in the elective group and simple diverticulitispatients. None of the patients had anastomosis-related complications. Two patients had stoma-related complications. CONCLUSION: Laparoscopic management of diverticulitis is feasible, safe, provides the benefits of less wound-related complications, and shorter hospital stay and should be the surgical procedure of choice in elective or emergency setting for simple/complicated diverticulitis.
Authors: M A Carbajo Caballero; J C Martín del Olmo; J I Blanco Alvarez; F Martín Acebes; C De la Cuesta de la Llave; R Atienza Sánchez; M Toledano Trincado; C Vaquero Puerta Journal: Rev Esp Enferm Dig Date: 2000-11 Impact factor: 2.086
Authors: Sandra Vennix; Gijsbert D Musters; Irene M Mulder; Hilko A Swank; Esther C Consten; Eric H Belgers; Anna A van Geloven; Michael F Gerhards; Marc J Govaert; Wilhelmina M van Grevenstein; Anton G Hoofwijk; Philip M Kruyt; Simon W Nienhuijs; Marja A Boermeester; Jefrey Vermeulen; Susan van Dieren; Johan F Lange; Willem A Bemelman Journal: Lancet Date: 2015-07-22 Impact factor: 79.321