Laparoscopic resection of diverticular fistulae: a 10-year experience.
OBJECTIVE
Until recently the laparoscopic approach was reserved for uncomplicated diverticular disease. We show that fistulating diverticular disease can be resected safely, with good clinical outcome via a laparoscopic approach.


METHODS
Between April 1994 and May 2005, 31 consecutive patients [17 male, median age of 63 years (range 40-85)], underwent attempted laparoscopic resection for diverticular fistulae. Patient data were prospectively recorded.


RESULTS
There were 22 colovesical and nine colovaginal fistulae. The median operative time was 150 min (range 60-310) and the median postoperative stay was 7 days (range 3-21). Conversion to an open procedure was required in nine of 31 patients (29%). This rate fell to 10% in cases performed after April 2000. There were two nonsurgically related postoperative deaths. Both occurred in the converted group. At 3 months follow-up, two patients complained of frequency of stools, which settled by 6 months. To date there has been no recurrence of symptomatic diverticulosis or fistulation.


CONCLUSIONS
Totally laparoscopic resection for diverticular fistulae is safe and feasible. Fistulae should not be considered as a contraindication to laparoscopic resection for an experienced laparoscopic surgeon.
Engledow
A H
AH
Colchester General Hospital, Colchester, Essex, UK. alecengledow@hotmail.com
Pakzad
F
F
Ward
N J
NJ
Arulampalam
T
T
Motson
R W
RW
D000328:Adult; D000368:Aged; D004238:Diverticulitis / Q000601:surgery*; D004239:Diverticulitis, Colonic / Q000601:surgery* / Q000628:therapy; D005260:Female; D013502:General Surgery / Q000379:methods; D006801:Humans; D007412:Intestinal Fistula / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D016896:Treatment Outcome