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An outcome analysis of laparoscopic management of diverticulitis

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Abstract

Background

All operative procedures for simple or complicated diverticulitis, including primary resection and anastomosis (PRA) with or without a diverting stoma, Hartmann procedure (HP), or stoma reversal, whether done in an elective setting or as an emergency, can be performed laparoscopically. However, owing to low incidence of the disease and complexity of the procedure, there are very few studies on outcomes of laparoscopic surgery for sigmoid diverticulitis from India.

Aim

The present study was undertaken to evaluate outcomes of laparoscopically treated patients of sigmoid diverticulitis.

Methods

Prospective observational study enrolled 37 patients with sigmoid diverticulitis managed laparoscopically from March 2015 to March 2017. Demographic, clinical, operative, postoperative, and complication data were entered into a patient proforma and analyzed.

Results

Eleven simple and 26 complicated diverticulitis patients were operated laparoscopically, 22 in emergency setting and 15 in elective setting. Only three patients required conversion to open surgery—two due to dense adhesions and one due to chronic obstructive pulmonary disease (COPD). No patients had ureteric or bowel injury. Eighteen patients underwent laparoscopic PRA without stoma, 11 patients had PRA with stoma, 6 had HP, and 2 had laparoscopic lavage. Results showed lesser blood loss, shorter hospital stay, and fewer complications in the elective group and simple diverticulitis patients. None of the patients had anastomosis-related complications. Two patients had stoma-related complications.

Conclusion

Laparoscopic management of diverticulitis is feasible, safe, provides the benefits of less wound-related complications, and shorter hospital stay and should be the surgical procedure of choice in elective or emergency setting for simple/complicated diverticulitis.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Lilavati Hospital and Research Center, A-791, Bandra Reclamation Road, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, 400 050, India

    Gunjan S. Desai, Rajvilas Narkhede, Prasad Pande, Paresh Varty & Hitesh Mehta

  2. Department of Gastrointestinal Surgery, King Edward Memorial Hospital, Parel, Mumbai, 400 012, India

    Bhushan Bhole

Authors
  1. Gunjan S. Desai
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  2. Rajvilas Narkhede
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  3. Prasad Pande
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  4. Bhushan Bhole
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  5. Paresh Varty
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  6. Hitesh Mehta
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Contributions

All authors have contributed to the formulation of the paper, data collection, and literature review. Overall guidance by the consultant Dr. Hitesh Mehta and drafting and figure acquisition by the residents.

Corresponding author

Correspondence to Gunjan S. Desai.

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Conflict of interest

GSD, RN, PP, BB, PV, and HM declare that they have no conflict of interest.

Ethics statement

The study was performed in a manner to conform to the Helsinki Declaration of 1975, as revised in 2000 and 2008, concerning human and animal rights, and the authors followed the policy concerning informed consent as shown in springer.com.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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The authors are solely responsible for the data and the content of the paper. In no way the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/findings and content of this article.

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Desai, G.S., Narkhede, R., Pande, P. et al. An outcome analysis of laparoscopic management of diverticulitis. Indian J Gastroenterol 37, 430–438 (2018). https://doi.org/10.1007/s12664-018-0907-0

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  • DOI: https://doi.org/10.1007/s12664-018-0907-0

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