Laparoscopic surgery has no adverse impact on patients with diverticulitis

The latest issue of Surgical Endoscopy investigates the impact of diverticulitis on laparoscopic surgery conversion rates and patient outcomes.

Dr Imran Hassan and colleagues from Minnesota, USA determined the impact of complicated and uncomplicated diverticulitis on conversion rates and complications in patients undergoing laparoscopic surgery for diverticular disease.

The team assessed 125 patients who underwent laparoscopic surgery between 1993 and 2004.

Of these, 91 received laparoscopic-assisted and 34 had hand-assisted colectomy for diverticular disease.

The research team reported that 79 patients had uncomplicated, and 46 had complicated diverticular disease.

The conversion rate was 26%

Surgical Endoscopy

Cases not completed laparoscopically were considered converted.

Complicated diverticulitis was defined as diverticular disease associated with abscess, fistula, bleeding or stricture.

The researchers noted that the mean age of patients was 59 years, and 54% were men with a mean follow-up of 23 months.

The conversion rate was 26%.

The team observed that the only factor independently associated with conversion was a history of previous abdominal surgery.

The team evaluated a subset of patients undergoing surgery for uncomplicated diverticulitis.

The number of diverticulitis episodes, the time between the first and last diverticulitis episodes were not associated with conversion in this subset.

The researchers noted that the time between the last diverticulitis episodes and surgery was also not significantly associated with conversion.

The team found that early complications, less than 30 days from surgery, occurred in 25% of patients.

The team observed 21 long-term complications in 20 patients.

The 1 and 2-year cumulative probabilities of these complications were 14% and 22%, respectively.

Early complications were significantly higher among patients requiring conversion but were not significantly higher among patients with complicated diverticulitis.

The team found that the rates of long-term complications were not significantly higher among patients that required conversion or had complicated diverticulitis.

Dr Hassan's team concluded, "A previous history of abdominal surgery was associated with a higher conversion rate in patients undergoing laparoscopic surgery for diverticular disease."

"Long-term patient outcomes are not adversely impacted by laparoscopic surgery for complicated diverticulitis or laparoscopic surgery requiring conversion to an open procedure."