Laparoscopy Improves Short-term Outcomes After Surgery for Diverticular Disease

Overview

Journal Gastroenterology

Specialty Gastroenterology

Date 2010 Mar 3

PMID 20193685

Citations 8

Authors

Andrew J Russ

Kari L Obma

Victoria Rajamanickam

Yin Wan

Charles P Heise

Eugene F Foley

Bruce Harms

Gregory D Kennedy

Affiliations

Soon will be listed here.

Abstract

Background & Aims: Observational studies and small randomized controlled trials have shown that the use of laparoscopy in colon resection for diverticular disease is feasible and results in fewer complications. We analyzed data from a large, prospectively maintained, multicenter database (National Surgical Quality Initiative Program) to determine whether the use of laparoscopy in the elective treatment of diverticular disease decreases rates of complications compared with open surgery, independent of preoperative comorbid factors.

Methods: The analysis included data from 6970 patients who underwent elective surgeries for diverticular disease from 2005 to 2008. Patients with diverticular disease were identified by International Classification of Diseases, 9th revision codes and then categorized into open or laparoscopic groups based on Current Procedural Terminology codes. Preoperative, intraoperative, and postoperative data were analyzed to determine factors associated with increased risk for postoperative complications.

Results: Data were analyzed from 3468 patients who underwent open surgery and 3502 patients who underwent laparoscopic procedures. After correcting for probability of morbidity, American Society of Anesthesiology class, and ostomy creation, overall complications (including superficial surgical site infections, deep incisional surgical site infections, sepsis, and septic shock) occurred with significantly lower incidence among patients who underwent laparoscopic procedures compared with those who received open operations.

Conclusions: The use of laparoscopy for treating diverticular disease, in the absence of absolute contraindications, results in fewer postoperative complications compared with open surgery.

Citing Articles

Risk Factors Associated with Postoperative Outcomes in Diverticular Disease Undergoing Elective Colectomy-A Retrospective Cohort Study from the ACS-NSQIP Database.

Hu W, Eisenstein S, Parry L, Ramamoorthy S J Clin Med. 2023; 12(23).

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Current evidence on laparoscopic vs. open resection for gastric stromal tumours.

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Short-term outcomes of minimally invasive versus open colectomy for colon cancer.

Papageorge C, Zhao Q, Foley E, Harms B, Heise C, Carchman E J Surg Res. 2016; 204(1):83-93.

PMID: 27451872 PMC: 6475900. DOI: 10.1016/j.jss.2016.04.020.

National Trends in Short-term Outcomes Following Non-emergent Surgery for Diverticular Disease.

Papageorge C, Kennedy G, Carchman E J Gastrointest Surg. 2016; 20(7):1376-87.

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Agabiti N, Stafoggia M, Davoli M, Fusco D, Barone A, Perucci C BMJ Open. 2013; 3(2).

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References

Young-Fadok T, HallLong K, McConnell E, Gomez Rey G, Cabanela R . Advantages of laparoscopic resection for ileocolic Crohn's disease. Improved outcomes and reduced costs. Surg Endosc. 2001; 15(5):450-4. DOI: 10.1007/s004640080078. View

Agachan F, Joo J, Sher M, Weiss E, Nogueras J, Wexner S . Laparoscopic colorectal surgery. Do we get faster?. Surg Endosc. 1997; 11(4):331-5. DOI: 10.1007/s004649900357. View

Vargas H, Ramirez R, HOFFMAN G, Hubbard G, Gould R, Wohlgemuth S . Defining the role of laparoscopic-assisted sigmoid colectomy for diverticulitis. Dis Colon Rectum. 2001; 43(12):1726-31. DOI: 10.1007/BF02236858. View

Dwivedi A, Chahin F, Agrawal S, Chau W, Tootla A, Tootla F . Laparoscopic colectomy vs. open colectomy for sigmoid diverticular disease. Dis Colon Rectum. 2002; 45(10):1309-14; discussion 1314-5. DOI: 10.1007/s10350-004-6415-6. View

WELCH C, ALLEN A, DONALDSON G . An appraisal of resection of the colon for diverticulitis of the sigmoid. Ann Surg. 1953; 138(3):332-43. PMC: 1609560. DOI: 10.1097/00000658-195313830-00005. View

Wishner J, Baker Jr J, HOFFMAN G, Hubbard 2nd G, Gould R, Wohlgemuth S . Laparoscopic-assisted colectomy. The learning curve. Surg Endosc. 1995; 9(11):1179-83. DOI: 10.1007/BF00210923. View

Tekkis P, Senagore A, Delaney C . Conversion rates in laparoscopic colorectal surgery: a predictive model with, 1253 patients. Surg Endosc. 2004; 19(1):47-54. DOI: 10.1007/s00464-004-8904-z. View

HOFFMAN G, Baker J, FITCHETT C, VANSANT J . Laparoscopic-assisted colectomy. Initial experience. Ann Surg. 1994; 219(6):732-40; discussion 740-3. PMC: 1243234. DOI: 10.1097/00000658-199406000-00018. View

Kennedy G, Heise C, Rajamanickam V, Harms B, Foley E . Laparoscopy decreases postoperative complication rates after abdominal colectomy: results from the national surgical quality improvement program. Ann Surg. 2009; 249(4):596-601. DOI: 10.1097/SLA.0b013e31819ec903. View

10.

Rafferty J, Shellito P, Hyman N, Buie W . Practice parameters for sigmoid diverticulitis. Dis Colon Rectum. 2006; 49(7):939-44. DOI: 10.1007/s10350-006-0578-2. View

11.

Agachan F, Joo J, Weiss E, Wexner S . Intraoperative laparoscopic complications. Are we getting better?. Dis Colon Rectum. 1996; 39(10 Suppl):S14-9. DOI: 10.1007/BF02053800. View

12.

Kozak L, DeFrances C, Hall M . National hospital discharge survey: 2004 annual summary with detailed diagnosis and procedure data. Vital Health Stat 13. 2006; (162):1-209. View

13.

Margenthaler J, Longo W, Virgo K, Johnson F, Grossmann E, Schifftner T . Risk factors for adverse outcomes following surgery for small bowel obstruction. Ann Surg. 2006; 243(4):456-64. PMC: 1448971. DOI: 10.1097/01.sla.0000205668.58519.76. View

14.

Senagore A, Duepree H, Delaney C, Dissanaike S, Brady K, Fazio V . Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease: similarities and differences. Dis Colon Rectum. 2002; 45(4):485-90. DOI: 10.1007/s10350-004-6225-x. View

15.

Senagore A, Luchtefeld M, Mackeigan J . What is the learning curve for laparoscopic colectomy?. Am Surg. 1995; 61(8):681-5. View

16.

Falk P, Beart Jr R, Wexner S, Thorson A, Jagelman D, Lavery I . Laparoscopic colectomy: a critical appraisal. Dis Colon Rectum. 1993; 36(1):28-34. DOI: 10.1007/BF02050298. View

17.

Marusch F, Gastinger I, Schneider C, Scheidbach H, Konradt J, Bruch H . Importance of conversion for results obtained with laparoscopic colorectal surgery. Dis Colon Rectum. 2001; 44(2):207-14; discussion 214-6. DOI: 10.1007/BF02234294. View

18.

Simons A, Anthone G, Ortega A, Franklin M, Fleshman J, Geis W . Laparoscopic-assisted colectomy learning curve. Dis Colon Rectum. 1995; 38(6):600-3. DOI: 10.1007/BF02054118. View

19.

Redwine D, Sharpe D . Laparoscopic segmental resection of the sigmoid colon for endometriosis. J Laparoendosc Surg. 1991; 1(4):217-20. DOI: 10.1089/lps.1991.1.217. View

20.

Bouillot J, Berthou J, Champault G, Meyer C, Arnaud J, Samama G . Elective laparoscopic colonic resection for diverticular disease: results of a multicenter study in 179 patients. Surg Endosc. 2002; 16(9):1320-3. DOI: 10.1007/s00464-001-9236-x. View