title: Surgical treatment of complicated right colonic diverticulitis: laparoscopic versus open surgery.
abstract: BACKGROUND
  Complicated right colonic diverticulitis is more common in Eastern countries. Although this disease entity is treated primarily with surgery, it is uncertain whether the outcomes of laparoscopic treatment also are comparable with those of open surgery. This study aimed to evaluate the outcome for laparoscopic surgical management of complicated right-sided colonic diverticulitis compared with that for open surgery.
  
  
  METHODS
  Between 1999 and 2011, 59 patients who underwent extensive surgery for complicated right colonic diverticulitis were enrolled from two hospitals. All the patients were suspected of having a large abscess or perforation with peritonitis symptoms preoperatively. Laparoscopic surgery was performed for 28 consecutive patients in the one hospital, and open surgery was performed for 31 consecutive patients in the other hospital. There was no conversion in the laparoscopic surgery cases. Clinical outcomes were analyzed and compared between the two groups.
  
  
  RESULTS
  Laparoscopic surgery had a longer operating time (165 min) than open surgery (132 min) (p = 0.003). The two groups did not differ significantly in terms of postoperative hospital stay (laparoscopy 9.8 ± 2.7 days versus open surgery 12.8 ± 8.8 days; p = 0.234) or resumption of diet (laparoscopy 5.5 ± 2.4 days versus open surgery 6.3 ± 3.0 days; p = 0.286). Five patients in the laparoscopy group (17.8 %) had complications such as ileus, abscess, and bleeding, one of whom was treated with surgery. Nine patients in the open surgery group (29 %) had complications, two of whom were treated with surgery.
  
  
  CONCLUSIONS
  The laparoscopic approach to complicated right colonic diverticulitis may be feasible. The clinical outcomes were comparable with those for open surgery.
authors.affiliation: Department of Surgery, Hallym University College of Medicine, 896 Pyeongchon-dong, Dongan-gu, Anyang, 431-070, Republic of Korea. skunlvup@naver.com
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Kwon
authors.forename: Byung Seup
authors.initials: BS
authors.lastname: Kim
authors.forename: Hyoung-Chul
authors.initials: HC
authors.lastname: Park
authors.forename: Heung-Kwon
authors.initials: HK
authors.lastname: Oh
authors.forename: Rumi
authors.initials: R
authors.lastname: Shin
authors.forename: Seung-Bum
authors.initials: SB
authors.lastname: Ryoo
authors.forename: Kyu Joo
authors.initials: KJ
authors.lastname: Park
authors.forename: Bong Hwa
authors.initials: BH
authors.lastname: Lee
mesh_terms: D000328:Adult; D003082:Colectomy / Q000009:adverse effects; D004239:Diverticulitis, Colonic / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome