Laparoscopic colectomy for diverticulitis is not associated with increased morbidity when compared with non-diverticular disease

Schwandner, O.; Farke, S.; Bruch, Hans–Peter

doi:10.1007/s00384-004-0649-6

Cited by 43 publications

(27 citation statements)

References 36 publications

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“…Die akute komplizierte Sigmadivertikulitis scheint per se ein erhöhtes Konversionsrisiko zu haben wie bereits Schwandner et al (p=0,001) und Marusch et al zeigten [14,18,20]. In unserer Serie bestätigt sich dies ebenfalls.…”

Section: Laparoskopische Resektion Bei Komplizierter Divertikulitisunclassified

Ergebnisse der Sigmaresektion bei akuter und komplizierter Divertikulitis

Ritz

Reißfelder

Holmer

et al. 2008

Chirurg

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Section: Laparoskopische Resektion Bei Komplizierter Divertikulitisunclassified

Ergebnisse der Sigmaresektion bei akuter und komplizierter Divertikulitis

Ritz

Reißfelder

Holmer

et al. 2008

Chirurg

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“…A recently published meta-analysis concerning laparoscopic surgery in diverticulitis showed less intraoperative blood loss, shorter hospital stay, reduced need of analgesia, earlier beginning of solid diet, and reduced morbidity and major complications compared to open surgery [21]. To date, published studies are still controversial concerning the ideal timing of the surgical intervention in acute diverticulitis [1,2,10,12,13,16,17,[22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Based on the findings of Siewert et al [27], early elective surgery has gained increasing interest, because it is associated with good outcome and low morbidity [19], and it significantly increases the patient's quality of life and social function [20,36].…”

Section: Introductionmentioning

confidence: 99%

“…The ultimate goal of the surgical intervention is the removal of the disease with prevention of its recurrence and restoration of bowel continuity whenever possible [11]. Elective laparoscopic colectomy has become a standard procedure for symptomatic diverticular disease [11][12][13][14][15][16]. It can be safely performed even in complicated diverticulitis [17] and has a better outcome than laparotomy [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Acute Recurrent Diverticulitis: Early Elective or Late Elective Surgery. An Analysis of 237 Patients

et al. 2012

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Background The optimal timing of elective surgery in diverticulitis remains unclear. We attempted to investigate early elective versus late elective laparoscopic surgery in acute recurrent diverticulitis in a retrospective study. Method Data of patients undergoing elective laparoscopic surgery for diverticulitis were retrospectively gathered, including Hinchey stages I-II a/b. The primary endpoint was in-hospital complications according to the ClavienDindo classification. Secondary endpoints were surgical complications, operative time, conversion rate, and length of hospital stay. Results Of 237 patients, 81 (34%) underwent early elective operation (group A) and 156 (66%) underwent late elective operation (group B). In-hospital complications developed in 32% in group A and in 34% in group B (risk difference 2%, 95% Confidence Interval (95% CI): -11%, 14%). Higher age (p = 0.048) and borderline higher American Society of Anesthesiologists score (p = 0.056) were risk factors for in-hospital complications. Severe surgical complications occurred in 9% of patients in group A and 10% in group B (risk difference 2%, 95% CI: -6%, 9%). Conversion rate was 9% in group A and 3% in group B (p = 0.070). Severity of disease did not seem to have an impact on complications or length of hospital stay. The median postoperative hospital stay was 8 days in both groups (interquartile range 6-10). Mean operative time was 220 min (SD 64) in group A and 202 min (SD 48) in group B. Conclusions This is the first study comparing early versus late elective surgery for diverticulitis in terms of the postoperative outcome using a validated classification. Although the retrospective setting and large confidence intervals don't allow definitive recommendations, these results are of utmost importance for the design of future prospective, randomized controlled trials.

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“…A taxa de conversão apresentou redução significativa (8% para 1,5%) comparando os primeiros 100 casos com os 400 posteriores. 37 Comparando os resultados da colectomia laparoscópica em 363 pacientes com doença diverticular e 313 com doença não diverticular, Schwandner et al 38 concluíram que as taxas de conversão, complicação, mortalidade e necessidade de re-operação são similares entre os dois grupos.…”

Section: Acesso Cirúrgico Eletivounclassified

Atualização no tratamento da diverticulite aguda do cólon

Dias

Gondim

Nahas

2009

Rev bras. colo-proctol.

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RESUMO: Nas últimas décadas a incidência da moléstia diverticular do cólon e de suas complicações tem aumentado. Durante esse período o número de publicações a respeito do tema se expandiu, bem como as opções terapêuticas. Apesar disso, muitas dúvidas persistem e as decisões terapêuticas continuam relativamente imutadas, baseadas muitas vezes em dados antigos e de baixo poder estatístico. Nesta revisão apresentamos as evidências científicas atuais acerca da terapêutica desta complexa patologia. A doença diverticular pode ocorrer em todo o cólon, porém a região mais frequentemente acometida é o sigmoide e raramente há doença abaixo da reflexão peritoneal. A doença diverticular do cólon direito, padrão predominante nas populações asiáticas, raramente acomete a população ocidental. DescritoresEstima-se que 30% da população com mais de 60 anos e 60% dos indivíduos com mais de 80 anos sejam afetados.2 Com o envelhecimento global da população, espera-se que a doença diverticular e suas complicações representem uma porcentagem cada vez maior do atendimento do cirurgião, tanto em consultó-rios como em emergências. 3O foco desta revisão, dentre a miríade de manifestações clínicas possíveis da doença diverticular (ausência de sintomas, queixas vagas e inespecíficas, sangramento intestinal etc.) será o abdome agudo (diverticulite) e os dados mais recentes acerca do tratamento desta que é a manifestação mais grave e mór-bida da diverticulose cólica.Estima-se que 10-25 % dos pacientes com diverticulose cólica evoluirão com diverticulite, sendo que 95% das vezes essa complicação ocorrerá no sigmoide.4,5 Destes, um quarto evoluirá com complicações potencialmente ameaçadoras à vida como: perfuração, fístula, obstrução ou estenose. 3Ainda hoje e apesar de existirem guidelines de diversas sociedades acerca do tratamento da diverticulite aguda, muitas dúvidas persistem: Quando indicar a cirurgia? Qual cirurgia devemos realizar? Qual

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Laparoscopic colectomy for diverticulitis is not associated with increased morbidity when compared with non-diverticular disease

Cited by 43 publications

References 36 publications

Ergebnisse der Sigmaresektion bei akuter und komplizierter Divertikulitis

Ergebnisse der Sigmaresektion bei akuter und komplizierter Divertikulitis

Surgical Treatment of Acute Recurrent Diverticulitis: Early Elective or Late Elective Surgery. An Analysis of 237 Patients

Atualização no tratamento da diverticulite aguda do cólon

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