Elective laparoscopic sigmoid colectomy for diverticulitis

Smadja, Claude; Idrissi, M. Sbai; Tahrat, M.; Vons, C.; Bobocescu, E; Baillet, P; Franco, Dominique

doi:10.1007/s004649901065

Cited by 57 publications

(34 citation statements)

References 14 publications

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“…The risk-benefit analysis of such an approach must be tailored with consideration of severity and responsiveness of the episode, general health of the patient, and risk of subsequent occurrence. Risk of resection is an evolving factor, with reports of increasingly favorable experiences with laparoscopic resections for diverticular disease [44][45][46][47][48][49] . This approach might reduce the threshold for resection in some patients by lowering operative morbidity.…”

Section: Diverticulitismentioning

confidence: 99%

Diverticular Disease in the Elderly

Comparato

Pilotto

Franzè

et al. 2007

Dig Dis

125

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There are few diseases whose incidence varies as greatly worldwide as that of diverticulosis. Its prevalence is largely age-dependent: the disease is uncommon in those under the age of 40, the prevalence of which is estimated at approximately 5%; this increases to 65% in those ≧65 years of age. Of patients with diverticula, 80–85% remain asymptomatic, while, for unknown reasons, only three-fourths of the remaining 15–20% of patients develop symptomatic diverticular disease. Traditional concepts regarding the causes of colonic diverticula include alterations in colonic wall resistance, disordered colonic motility and dietary fiber deficiency. Currently, inflammation has been proposed to play a role in diverticular disease. Goals of therapy in diverticular disease should include improvement of symptoms and prevention of recurrent attacks in symptomatic, uncomplicated diverticular disease, and prevention of the complications of disease such as diverticulitis. Diverticulitis is the most usual clinical complication of diverticular disease, affecting 10–25% of patients with diverticula. Most patients admitted with acute diverticulitis respond to conservative treatment, but 15–30% require surgery. Predictive factors for severe diverticulitis are sex, obesity, immunodeficiency and old age. Surgery for acute complications of diverticular disease of the sigmoid colon carries significant rates of morbidity and mortality, the latter of which occurs predominantly in cases of severe comorbidity. Postoperative mortality and morbidity are to a large extent driven by patient-related factors.

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Section: Diverticulitismentioning

confidence: 99%

Diverticular Disease in the Elderly

Comparato

Pilotto

Franzè

et al. 2007

Dig Dis

125

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“…The advantages and development of laparoscopic surgical techniques have led the laparoscopic rectosigmoid resection to be a widely accepted treatment for complicated diverticulitis [9][10][11][12][13][14][15]. Controversy exists about the optimal timing of surgery, the type of procedure, and whether the laparoscopic approach should be recommended in acute complicated diverticulitis [16,17].…”

Section: Discussionmentioning

confidence: 99%

Acute laparoscopic intervention for diverticular disease (AIDD): a feasible approach

Zdichavsky¹,

Granderath

Blumenstock

et al. 2008

Langenbecks Arch Surg

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“…It is consensus to remove only the diseased segment of the colon (mainly the sigmoid colon), and the distal resection line should be below the rectosigmoid junction to ensure a colorectal anastomosis [9,15,16]. Although laparoscopic sigmoid colectomy has been shown to be feasible and effective by many series in the 1990s [3,17,18,19,20,21,22,23,24,25,26,27,28], the general acceptance of laparoscopic sigmoid resection for diverticular disease has developed slowly and gradually, because it involves extensive mesocolic dissection, mobilisation of the splenic flexure, intracorporeal division of vessels and removal of an inflamed colonic segment with creation of a colorectal anastomosis. In the reported series of laparoscopic colectomy for diverticulitis, there are some technical variations that need to be considered.…”

Section: Discussionmentioning

confidence: 99%