Elective laparoscopic management of sigmoid diverticulitis. Results in a series of 110 patients

Abstract

Background: The aim of this study was to evaluate the results of elective laparoscopic treatment of sigmoid diverticulitis.

Methods: Between November 1991 and February 1998, 110 patients were treated by elective laparoscopic colectomy for sigmoid diverticulitis. The main data recorded were postoperation pain, return of bowel function, operation time, duration of hospital stay, and early and late complications.

Results: Mean age of patients was 63 years (range, 36-83 years). Nine patients (8.2%) required conversion to laparotomy because of severe adhesions, inflammatory process, or obesity. The mean operation time was 167 min. Return of bowel function was 2.3 days. Mean postoperation stay was 8.2 days. There was no perioperation death, and the morbidity rate was 7.3%, with two complications related to the laparoscopic approach (1 trocar site bowel incarceration and 1 small bowel fistula). Of the patients with complications, four (3.6%) needed reoperation. During the follow-up (6-79 months), no incisional hernia was observed.

Conclusions: Laparoscopic colectomy for sigmoid diverticulitis is feasible and safe in more than 90% of cases. Benefits of the laparoscopic approach are the improved early postoperation course and the reduction of parietal sequelae.