Increasing the number of attacks increases the conversion rate in laparoscopic diverticulitis surgery |
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Authors: | Karin Cole Steven Fassler Sree Suryadevara D Mark Zebley |
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Institution: | (1) Department of Surgery, Abington Memorial Hospital, Price Medical Office Building, Suite 604, 1245 Highland Avenue, Abington, PA 19001, USA |
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Abstract: | Background This study aimed to determine whether the number of diverticulitis or complicated diverticulitis episodes affects the conversion
rate or postoperative complication rate in elective laparoscopic sigmoid colectomy.
Methods In this study, 216 charts were reviewed for baseline characteristics, diverticulitis history, and intra- and postoperative
complications. Analysis was performed with the Student’s t-test, the chi-square test, and Fisher’s exact tests.
Results Of 216 sigmoid colectomies, 151 were laparoscopic, 19 were converted, and 46 were open. Baseline characteristics were similar
for patients with zero to two and those with three or more inpatient diverticulitis attacks. Patients with uncomplicated diverticulitis
had a higher rate of conversion after three or more inpatient episodes (2.6% vs 25%; p = 0.04). There was no difference in operative times or postoperative complication rates. Patients with a history of abscess
had a 23% chance of conversion. Those with no abscess history had an 8% chance of conversion (p = 0.02). In general, converted procedures required more time than open procedures but were associated with decreased hospital
length of stay (LOS) and a decreased rate of postoperative ileus.
Conclusion Multiple inpatient diverticulitis attacks and a history of abscess were associated with laparoscopic conversion. Converted
procedures required more time than open procedures, but had reduced LOS and postoperative ileus. Laparoscopic sigmoid colectomy
can be attempted safely for patients with three or more inpatient attacks or a history of complicated diverticulitis. |
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Keywords: | Complicated diverticulitis Conversion Diverticulitis Laparoscopic colorectal surgery Sigmoid colectomy |
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