title: Predictive risk factors for intra- and postoperative complications in 526 laparoscopic sigmoid resections due to recurrent diverticulitis: a multivariate analysis.
abstract: BACKGROUND
  Laparoscopic sigmoid resection is a feasible and frequent operation for patients who suffer from recurrent diverticulitis. There is still an ongoing debate about the optimal timing for surgery in patients who suffer from recurrent diverticulitis episodes. In elective situations the complication rate for this procedure is moderate, but there are patients at high risk for perioperative complications. The few identified risk factors so far refer to open surgery. Data for the elective laparoscopic approach is rare. The objective of this study was to identify potential predictive risk factors for intra- and postoperative complications in patients who underwent laparoscopic sigmoid resection due to diverticular disease.
  
  
  METHODS
  Uni- and multivariate analyses of a prospectively gathered database (1993-2006) were performed on a consecutive series of 526 patients who underwent laparoscopic sigmoid resection due to recurrent diverticulitis in a single institution. Patients were assessed for demographic data, operative indications, and intra- and postoperative complications. Altogether, we analyzed 17 potential risk factors to identify significant influence on the intra- and postoperative outcome, including timing of surgery.
  
  
  RESULTS
  Statistical analysis of specific medical and surgical complications revealed anemia, previous myocardial infarction, heart failure, experience of the surgeon, and male gender, as independent predictive risk factors for postoperative complications. Patients older than age 75 years was the only independent risk factor for intraoperative complications in a multiple logistic regression model. Early elective surgery led to increased conversion rate but did not influence the postoperative complication rate.
  
  
  CONCLUSIONS
  This large, single-center study provides first evidence of the significance of specific predictive risk factors for intra- and postoperative complications in laparoscopic sigmoid resection for diverticular disease.
authors.affiliation: Department of Surgery, City Hospital Waid, Tièche-Strasse 99, 8037 Zurich, Switzerland. pkirchhoff@hotmail.com
authors.forename: Philipp
authors.initials: P
authors.lastname: Kirchhoff
authors.forename: Daniel
authors.initials: D
authors.lastname: Matz
authors.forename: Selim
authors.initials: S
authors.lastname: Dincler
authors.forename: Peter
authors.initials: P
authors.lastname: Buchmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D016208:Databases, Factual; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000601:surgery*; D013557:Switzerland