Laparoscopic sigmoid colectomy for complicated diverticulitis is safe: review of 576 consecutive colectomies

Bhakta, Avinash; Tafen, Marcel; Glotzer, Owen; Canete, Jonathan J.; Chismark, A David; Valerian, Brian T.; Stain, Steven C.; Lee, Edward C.

doi:10.1007/s00464-015-4393-5

Cited by 44 publications

(23 citation statements)

References 20 publications

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“…Previous studies have shown that a laparoscopic colectomy can be safely utilized for complicated diverticulitis; however, most reports were limited by exceedingly small cohorts and highly selected patients [11,[14][15][16]. In a recent large study of 111 consecutive diverticular fistula cases with minimal exclusion, reported by Martinolich et al [22], the overall incidence of postoperative complications was 26.4%.…”

Section: Discussionmentioning

confidence: 99%

“…Several small retrospective studies on diverticular fistulas have reported that the incidence of COS ranges from 0 to 50%, [9,[11][12][13][14][15][16][17][18][19][20] and patients with a preoperative diagnosis of CVF were most likely to require COS. Recent studies on CVF by Badic et al [14] and Martinolich et al [22] reported COS incidence rates of 43% and 42%, respectively, comparable to our rate of 27%.…”

Section: Discussionmentioning

confidence: 99%

“…The median timing of Foley catheter removal was postoperative day 7 (range of 3-11), and the median hospital stay was 13 days (range of [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. No reoperations or mortalities occurred (Table 1).…”

Section: Intraoperative and Postoperative Outcomesmentioning

confidence: 99%

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Laparoscopic surgery for diverticular colovesical fistula: Single–center experience of 11 cases

Kitaguchi

Enomoto

Ohara

et al. 2020

Preprint

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Objective: Laparoscopic surgery for diverticular colovesical fistula (CVF) is technically challenging, and the incidence of conversion to open surgery (COS) is high. The aims of this study were to review our experience with laparoscopic surgery for diverticular CVF and to identify preoperative risk factors for COS. Results: This was a single institution, retrospective, observational study of 11 patients who had undergone laparoscopic sigmoid colon resection with fistula resection for diverticular CVF from 2014 to 2019. Preoperative magnetic resonance imaging (MRI) was utilized to evaluate fistula location in the bladder, patency of the rectovesical pouch, and estimated contact area between the sigmoid colon and bladder. The relationship between preoperative variables and incidence of COS was analyzed between completed laparoscopy and COS groups. The overall incidence of postoperative morbidity (Clavien–Dindo classification Grade II or higher) was 36% (4/11). Severe morbidity, reoperation, and mortality were not observed. The incidence of COS was 27% (3/11). Posterior bladder fistulas were significantly associated with COS ( p = 0.006 ). CVFs located on the posterior bladder appears to be a risk factor for COS. Identifying the risk factors for COS preoperatively could help guide the intraoperative course.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic surgery for diverticular colovesical fistula: Single–center experience of 11 cases

Kitaguchi

Enomoto

Ohara

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…UTIs occurred in two patients, and ileus and pelvic abscess occurred in one each. The median timing of Foley catheter removal was postoperative day 7 (range of 3-11), and the median hospital stay was 13 days (range of [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. No reoperations or mortalities occurred (Table 1).…”

Section: Intraoperative and Postoperative Outcomesmentioning

confidence: 99%

“…However, laparoscopic surgery for diverticular CVF is still technically challenging because of extensive inflammation and abscess formation. These complications may explain why the incidence of conversion to open surgery (COS) ranges from 0 to 50% [9,[11][12][13][14][15][16][17][18][19][20]. Identification of preoperative risk factors for COS is critical, as evaluating risk can help guide the decision on conversion during the surgery.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery for diverticular colovesical fistula: single-center experience of 11 cases

et al. 2020

View full text Add to dashboard Cite

Objective: Laparoscopic surgery for diverticular colovesical fistula (CVF) is technically challenging, and the incidence of conversion to open surgery (COS) is high. This study aimed to review our experience with laparoscopic surgery for diverticular CVF and identify preoperative risk factors for COS. Results: This was a single institution, retrospective, observational study of 11 patients (10 males and 1 female) who underwent laparoscopic sigmoid colon resection with fistula resection for diverticular CVF from 2014 to 2019. Preoperative magnetic resonance imaging (MRI) was performed to evaluate the fistula location in the bladder, patency of the rectovesical pouch (i.e., the destination of dissection procedure between sigmoid colon and bladder) and estimate the contact area between the sigmoid colon and bladder. The relationship between preoperative variables and COS incidence was analyzed between completed laparoscopy and COS groups. The overall incidence of postoperative morbidity (Clavien-Dindo classification Grade II or higher) was 36% (4/11). Severe morbidity, reoperation, and mortality were not observed. The incidence of COS was 27% (3/11). Posterior bladder fistulas were significantly associated with COS. CVFs located on the posterior bladder appears to be a risk factor for COS. Identifying risk factors for COS preoperatively could help guide the intraoperative course.

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Robotic elective colectomy for diverticular disease: short‐term outcomes of 80 patients

Formisano

Giuliani

Salaj

et al. 2020

Robotics Computer Surgery

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Background This study aimed to evaluate the impact of the robotic approach on the minimally invasive elective treatment of diverticular disease. Methods Data from patients who underwent elective robotic colectomy for diverticular disease from January 2015 to February 2020 were prospectively collected and retrospectively analysed. Intraoperative and 30‐day postoperative outcomes were the variables assessed. Results A total of 80 patients (71% with prior complicated diverticulitis) met the inclusion criteria. Mean operative time was 241 min, one intraoperative complication (1.2%) was observed, the conversion rate was 2.5%. Mean hospital stay was 6.4 days and overall 30‐day complication rate was 22.5%. Fourteen patients (17.5%) had minor complications, while major postoperative complications occurred in four patients (5%). Anastomotic leak rate was 3.9% and the 30‐day readmission rate was 3.7%. Conclusions Robotic colectomy for diverticular disease has proven to be feasible and safe, with low intraoperative complications, conversion, and anastomotic leak rates.

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Laparoscopic sigmoid colectomy for complicated diverticulitis is safe: review of 576 consecutive colectomies

Abstract: Complicated diverticulitis did not affect the conversion rate to an open procedure. However, patients with CD are prone to postoperative complications. The laparoscopic approach to sigmoid colectomy is safe and preferable in experienced hands.

Cited by 44 publications

References 20 publications

Laparoscopic surgery for diverticular colovesical fistula: Single–center experience of 11 cases

Laparoscopic surgery for diverticular colovesical fistula: Single–center experience of 11 cases

Laparoscopic surgery for diverticular colovesical fistula: single-center experience of 11 cases

Robotic elective colectomy for diverticular disease: short‐term outcomes of 80 patients

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