title: The evolving role of laparoscopy in colonic diverticular disease: a systematic review.
abstract: BACKGROUND
  A PubMed search of the biomedical literature was carried out to systematically review the role of laparoscopy in colonic diverticular disease. All original reports comparing elective laparoscopic, hand-assisted, and open colon resection for diverticular disease of the colon, as well as original reports evaluating outcomes after laparoscopic lavage for acute diverticulitis, were considered. Of the 21 articles chosen for final review, nine evaluated laparoscopic versus open elective resection, six compared hand-assisted colon resection versus conventional laparoscopic resection, and six considered laparoscopic lavage. Five were randomized controlled trials.
  
  
  RESULTS
  Elective laparoscopic colon resection for diverticular disease is associated with increased operative time, decreased postoperative pain, fewer postoperative complications, less paralytic ileus, and shorter hospital stay compared to open colectomy. Laparoscopic lavage and drainage appears to be a safe and effective therapy for selected patients with complicated diverticulitis.
  
  
  CONCLUSIONS
  Elective laparoscopic colectomy for diverticular disease is associated with decreased postoperative morbidity compared to open colectomy, leading to shorter hospital stay and fewer costs. Laparoscopic lavage has an increasing but poorly defined role in complicated diverticulitis.
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, Minneapolis, MN 55455, USA. gaert015@umn.edu
authors.forename: Wolfgang B
authors.initials: WB
authors.lastname: Gaertner
authors.forename: Mary R
authors.initials: MR
authors.lastname: Kwaan
authors.forename: Robert D
authors.initials: RD
authors.lastname: Madoff
authors.forename: David
authors.initials: D
authors.lastname: Willis
authors.forename: George E
authors.initials: GE
authors.lastname: Belzer
authors.forename: David A
authors.initials: DA
authors.lastname: Rothenberger
authors.forename: Genevieve B
authors.initials: GB
authors.lastname: Melton
mesh_terms: D016022:Case-Control Studies; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods; D043963:Diverticulosis, Colonic / Q000175:diagnosis / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome