A case-control study of laparoscopic versus open sigmoid colectomy for diverticulitis.
Laparoscopic sigmoid colectomy (LSC) for diverticular disease accounts for a limited number of laparoscopic colon cases performed nationally because of the technical challenge it presents. Our objective was to determine the feasibility and impact of the laparoscopic approach in elective sigmoid colectomy for diverticular disease and to compare these results with those of the open approach. Twenty elective laparoscopic sigmoid colectomies (LSCs) were performed for diverticulitis between April 1992 and July 1999 at a university-affiliated urban hospital. A case-control study was performed comparing LCS with a matched control group of conventional open sigmoidectomies. Fourteen of 20 sigmoidectomies were successfully completed laparoscopically. The mean operative time for LSC was similar to that for open sigmoid colectomy (251 vs 243 minutes). There was earlier return to oral intake in the LSC group (1 vs 5 days; P < 0.001). The mean length of stay was significantly shorter (P = 0.029) in LSC (4.8 days) versus open sigmoid colectomy (7.8 days). Conversion to open sigmoidectomy extended hospital stay to 8.16 days. The overall complication rate was 10 per cent in both groups. We conclude that LSC can be performed effectively and with a low complication rate for diverticular disease. LSC provides the benefit of quicker return of bowel function and shorter hospitalization.
Faynsod
M
M
Harbor UCLA Medical Center, Torrance, California 90509, USA.
Stamos
M J
MJ
Arnell
T
T
Borden
C
C
Udani
S
S
Vargas
H
H
D000328:Adult; D016022:Case-Control Studies; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D012809:Colon, Sigmoid / Q000503:physiopathology / Q000601:surgery*; D004239:Diverticulitis, Colonic / Q000601:surgery*; D004435:Eating / Q000502:physiology; D017558:Elective Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006760:Hospitalization; D006785:Hospitals, University; D006786:Hospitals, Urban; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000601:surgery*; D013997:Time Factors