title: Laparoscopic surgery for complicated diverticular disease: a single-centre experience.
abstract: OBJECTIVE
  The role of laparoscopic surgery in the management of patients with diverticular disease is still not universally accepted. The aim of our study was to evaluate the results of laparoscopic surgery for diverticular disease in a centre with a specialist interest in minimally invasive surgery.
  
  
  METHODS
  All diverticular resections carried out between 2006 and 2010 were reviewed. Data recorded included baseline demographics, indication for surgery, operative details, length of hospital stay and complications. Complicated diverticular disease was defined as diverticulitis with associated abscess, phlegmon, fistula, stricture, obstruction, bleeding or perforation.
  
  
  RESULTS
  One hundred and two patients (58 men) who had surgery for diverticular disease were identified (median age 59 years, range 49-70 years). Sixty-four patients (64%) had surgery for complicated diverticular disease. The indications were recurrent acute diverticulitis (37%), colovesical fistula (21%), stricture formation (17%) and colonic perforation (16%). Sixty-nine cases (88%) were completed by elective laparoscopy. Postoperative mortality was 0%. For elective cases there was no difference in morbidity rates between patients with complicated and uncomplicated diverticular disease. The overall anastomotic leakage rate was 1% and the wound infection rate 7%. There was a nonsignificant trend to higher conversion to open surgery in the elective group in complicated (11.4%) compared with uncomplicated patients (5.2%) (P=0.67). Electively, the rate of stoma formation was higher in the complicated (31.6%) than the uncomplicated group (5.2%) (P<0.02).
  
  
  CONCLUSIONS
  Laparoscopic surgery for both complicated and uncomplicated diverticular disease is associated with low rates of postoperative morbidity and relatively low conversion rates. Laparoscopic surgery is now the standard of care for complicated and uncomplicated diverticular disease in our institution.
authors.affiliation: Minimally Invasive Surgery Unit, Division of Colorectal Surgery, AMNCH, Tallaght Hospital, Dublin 24, Ireland. roydsj@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Royds
authors.forename: J M
authors.initials: JM
authors.lastname: O'Riordan
authors.forename: E
authors.initials: E
authors.lastname: Eguare
authors.forename: D
authors.initials: D
authors.lastname: O'Riordan
authors.forename: P C
authors.initials: PC
authors.lastname: Neary
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D003082:Colectomy; D003106:Colon / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D004239:Diverticulitis, Colonic / Q000150:complications / Q000601:surgery*; D004241:Diverticulum, Colon / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome