Elective laparoscopic recto-sigmoid resection for diverticular disease is suitable as a training operation.
OBJECTIVE
Some authors state that elective laparoscopic recto-sigmoid resection is more difficult for diverticular disease as compared with malignancy. For this reason, starting laparoscopic surgeons might avoid diverticulitis, making the implementation phase unnecessary long. The aim of this study was to determine whether laparoscopic resection for diverticular disease should be included during the implementation phase.


METHODS
All consecutive patients who underwent an elective laparoscopic recto-sigmoid resection in our hospital for diverticulitis or cancer from 2003 to 2007 were analysed.


RESULTS
A total of 256 consecutive patients were included in this prospective cohort study. One hundred and fifty-one patients were operated on for diverticulitis and 105 for cancer. There was no significant difference in operation time (168 vs. 172 min), blood loss (189 vs. 208 ml), conversion rates (9.9% vs. 11.4%), hospital stay (8 vs. 8 days), total number of peroperative (2.3% vs. 1.6%) or postoperative complications (21.9% vs. 26.9%). The occurrence of anastomotic leakages was associated with higher American Society of Anesthesiologists (ASA) classification, which differed between the groups (86.8% vs. 64.8% ASA I-II, p < 0.001).


CONCLUSIONS
Since there are no differences in operation time, blood loss, conversion rate and total complications, there is no need to avoid laparoscopic recto-sigmoid resection for diverticular disease early in the learning curve.
Bosker
Robbert
R
Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands. r.bosker@home.nl
Hoogenboom
Froukje
F
Groen
Henk
H
Hoff
Christiaan
C
Ploeg
Rutger
R
Pierie
Jean-Pierre
JP
D000368:Aged; D015331:Cohort Studies; D012809:Colon, Sigmoid / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000193:education*; D004239:Diverticulitis, Colonic / Q000601:surgery*; D004501:Education, Medical; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies