Article: The laparoscopic approach in the treatment of diverticular colon disease

Background And Objectives: The experience with treatment of diverticular colon disease (DCD) by the laparoscopic method is analyzed.

Methods: Between January 1994 and July 1997, a group of 22 patients with criteria for symptomatic diverticular disease in the descending and sigmoid colon underwent laparoscopy with average resections of 40 cm. Intra-abdominal mechanical anastomosis completed the procedure.

Results: The operative morbidity was 28%. Two cases, in acute diverticulitis phase, were reconverted to open surgery, and three cases presented postoperative rectorrhagia which ceased spontaneously. No long-term complications have been found. Postoperative hospitalization was 4-8 days (mean 5.5) and mean operative time was 165 minutes (range 120-240).

Conclusions: Nevertheless, the learning curve precise to practice this type of surgery, the acceptable morbity-mortality rates which the laparoscopic method presents, especially with these high-risk groups of patients (age > 65, high blood pressure, etc), encouraged us to modified the criteria indicating surgery for the disease, offering first choice operative treatment with efficiency and safety. However, we feel that those patients with acute complications of diverticular colon disease must be excluded initially for laparoscopic approach.

Citing Articles

[Medial mobilisation of the left hemicolon].

Sigel A, Zerz A, Molle B, Knaus J, Zund M, Thurnheer M Chirurg. 2004; 75(6):605-8.

PMID: 15098094 DOI: 10.1007/s00104-003-0809-1.

References

1.

Begos D, Arsenault J, Ballantyne G . Laparoscopic colon and rectal surgery at a VA hospital. Analysis of the first 50 cases. Surg Endosc. 1996; 10(11):1050-6. DOI: 10.1007/s004649900238. View

2.

CADY J, Godfroy J, Sibaud O . [Laparoscopic resection-anastomosis in diverticular sigmoiditis and its complications apropos of 65 cases]. Chirurgie. 1996; 121(5):350-3; discussion 353-4. View

3.

Eijsbouts Q, Cuesta M, de Brauw L, Sietses C . Elective laparoscopic-assisted sigmoid resection for diverticular disease. Surg Endosc. 1997; 11(7):750-3. DOI: 10.1007/s004649900442. View

4.

Jacobs M, Verdeja J, GOLDSTEIN H . Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc. 1991; 1(3):144-50. View

5.

Roberts P, Abel M, Rosen L, Cirocco W, Fleshman J, Leff E . Practice parameters for sigmoid diverticulitis. The Standards Task Force American Society of Colon and Rectal Surgeons. Dis Colon Rectum. 1995; 38(2):125-32. DOI: 10.1007/BF02052438. View

6.

Wexner S, Cohen S . Port site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg. 1995; 82(3):295-8. DOI: 10.1002/bjs.1800820305. View

7.

Croce E, Azzola M, Russo R, Golia M, Olmi S . Laparoscopic colectomy: the absolute need for a standard operative technique. JSLS. 1997; 1(3):217-24. PMC: 3016731. View

8.

Hewett P, Stitz R . The treatment of internal fistulae that complicate diverticular disease of the sigmoid colon by laparoscopically assisted colectomy. Surg Endosc. 1995; 9(4):411-3. DOI: 10.1007/BF00187162. View

9.

Fielding G, Lumley J, NATHANSON L, Hewitt P, Rhodes M, Stitz R . Laparoscopic colectomy. Surg Endosc. 1997; 11(7):745-9. DOI: 10.1007/s004649900441. View

10.

Bruce C, Coller J, Murray J, Schoetz Jr D, Roberts P, Rusin L . Laparoscopic resection for diverticular disease. Dis Colon Rectum. 1996; 39(10 Suppl):S1-6. DOI: 10.1007/BF02053798. View

11.

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

12.

Liberman M, Phillips E, Carroll B, Fallas M, Rosenthal R . Laparoscopic colectomy vs traditional colectomy for diverticulitis. Outcome and costs. Surg Endosc. 1996; 10(1):15-8. DOI: 10.1007/s004649910002. View

The Laparoscopic Approach in the Treatment of Diverticular Colon Disease