Laparoscopic versus open colonic resection for complicated diverticular disease in the emergency setting: a safe choice? A retrospective comparative cohort study

Am J Surg. 2015 Jun;209(6):992-8. doi: 10.1016/j.amjsurg.2014.07.017. Epub 2014 Oct 12.

Abstract

Background: We conducted a retrospective cohort study to compare the outcomes of laparoscopic colon resection (LCR) with open colon resection (OCR) for complicated diverticular disease (CDD) during emergent hospital admission.

Methods: Charts from all patients undergoing colon resection for CDD during emergent hospital admission at a single academic institution were reviewed. The primary outcomes were overall 30-day postoperative morbidity and mortality.

Results: From 2000 to 2010, 125 cases were retrieved (49 LCR and 86 OCR). Conversion rate was 5.1%. Overall morbidity significantly decreased with laparoscopic surgery compared with OCR. No mortality occurred with LCR. Prolonged ileus was less frequent (12.8% vs. 32.6%; P = .02), time to oral intake shorter (3 vs. 6 days; P < .01), and LOS shorter (5 vs. 8 days; P = .05) for LCR.

Conclusions: In our series, in the patients selected, LCR for CDD during emergent hospital admission appears to be a safe procedure associated with decreased morbidity, time to oral intake, and LOS compared with OCR.

Keywords: Acute care surgery; Acute complicated diverticulitis; Emergency surgery; Minimally invasive surgery.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Colectomy / methods*
  • Conversion to Open Surgery / statistics & numerical data
  • Diverticulitis, Colonic / mortality
  • Diverticulitis, Colonic / surgery*
  • Elective Surgical Procedures
  • Emergencies
  • Female
  • Humans
  • Laparoscopy*
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Treatment Outcome