title: Laparoscopic resection of chronic sigmoid diverticulitis with fistula.
abstract: OBJECTIVE
  A growing number of operations for sigmoid diverticulitis are being done laparoscopically. There is a paucity of data on the outcome of laparoscopy for sigmoid diverticulitis complicated by colonic fistula. The aim of this study was to compare the results of laparoscopic resection of sigmoid diverticulitis with and without colonic fistula.
  
  
  METHODS
  A retrospective review was conducted of all patients who underwent laparoscopic resection of sigmoid diverticulitis complicated by fistula at a single tertiary care institution over a 7-year period. Comparison was made with a group of patients who underwent resection for diverticulitis without fistula during the same study period.
  
  
  RESULTS
  Forty-two patients were analyzed (group 1: diverticular fistula, group 2: no fistula). The median age was similar (49 vs. 50 years, P = .68). A chronic abscess was present in 24% of patients in group 1 and 10% in group 2 (P = .40). Fistula types were colovesical (71%), colovaginal (19%), and colocutaneous (10%). Operation types were sigmoidectomy (57% vs. 81%) and anterior resection (43% vs. 19%) in groups 1 and 2, respectively (P = .18). Ureteral catheters were used more frequently in group 1 (67% vs. 33% [P = .06]). No difference was noted in operative time, blood loss, conversion rate, length of stay, overall complications, wound infection rate, readmission rate, reoperation rate, and mortality. All patients healed without fistula recurrence.
  
  
  CONCLUSIONS
  Patients with sigmoid diverticulitis with fistula can be successfully treated with laparoscopic excision, with similar outcomes for patients without fistula.
authors.affiliation: Department of Surgery, Kaiser Permanente, Los Angeles, CA, USA.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Abbass
authors.affiliation: Department of Surgery, Kaiser Permanente, Los Angeles, CA, USA.
authors.forename: Anna T
authors.initials: AT
authors.lastname: Tsay
authors.affiliation: Chair, Minimally Invasive and Robotic Surgery, 4760 Sunset Boulevard, Third Floor, Los Angeles, CA 90027, USA. maher.a.abbas@kp.org.
authors.forename: Maher A
authors.initials: MA
authors.lastname: Abbas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003108:Colonic Diseases / Q000150:complications* / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004238:Diverticulitis / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications* / Q000601:surgery*; D010535:Laparoscopy; D008875:Middle Aged; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000150:complications* / Q000601:surgery*