[Results of sigma resection in acute complicated diverticulitis : method and time of surgical intervention].
BACKGROUND
The aim of this study was to check the results of laparoscopic sigmoid resection for sigmoid diverticular disease with respect to stage of inflammation and time of surgical intervention.


METHODS
All patients were divided into four groups: uncomplicated (Group 1) vs complicated diverticular disease (Group 2), and depending on surgical intervention in early elective (4-8 days, Group A) vs late elective sigmoid resection (4-6 weeks, Group B).


RESULTS
At total of 244 patients underwent laparoscopically-assisted resection during the examination period. Differences in favor of Group 1 were found in duration of surgery (153 min vs 167 min), postoperative wound infections (3.55% vs 15.5%), and postoperative hospitalization period (12.2 days vs 14.6 days). Group A had more conversions (7.8% vs 0.9%), more minor complications (25.9% vs 12.9%), and more wound infections (16.4% vs 4.6%) than Group B.


CONCLUSIONS
Laparoscopic sigmoid resection can be performed in cases of complicated diverticulitis without significantly increasing their overall morbidity. Because of the lower complication rate, we recommend that patients with acute sigmoid diverticulitis receive initial antibiotic treatment and then undergo late elective laparoscopic sigmoid resection.
Ritz
J-P
JP
Chirurgische Klinik I, Abteilung für Allgemein-, Gefäss- und Thoraxchirurgie, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland. joerg-peter.ritz@charite.de
Reissfelder
C
C
Holmer
C
C
Buhr
H J
HJ
D000208:Acute Disease; D000368:Aged; D019072:Antibiotic Prophylaxis; D003082:Colectomy / Q000379:methods*; D012809:Colon, Sigmoid / Q000601:surgery; D003131:Combined Modality Therapy; D004239:Diverticulitis, Colonic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012810:Sigmoid Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology