title: The impact of delaying elective resection of diverticulitis on laparoscopic conversion rate.
abstract: BACKGROUND
  Guideline-concordant delay in elective laparoscopic colectomy for diverticulitis may result in repeated bouts of inflammation. We aimed to determine whether conversion rates from elective laparoscopic colectomy are higher after multiple episodes of diverticulitis.
  
  
  METHODS
  Prospective cohort study evaluating laparoscopic colectomy conversion rates for diverticulitis from 42 hospitals was conducted.
  
  
  RESULTS
  Between 2010 and 2013, 1,790 laparoscopic colectomies for diverticulitis (mean age 57.8 ± 13; 47% male) resulted in 295 (16.5%) conversions. Conversion occurred more frequently in nonelective operations (P < .001) and with fistula indications (P = .012). Conversion rates decreased with surgeon case volume (P = .028). Elective colectomy exclusively for episode-based indications (n = 784) had a conversion rate of 12.9%. Increasing episodes of diverticulitis were not associated with higher conversion rates, even among surgeons with similar experience levels.
  
  
  CONCLUSIONS
  Conversion from laparoscopic colectomy for diverticulitis did not increase after multiple episodes of diverticulitis. Delaying elective resection appears to not prevent patients from the benefits of laparoscopy.
mesh_terms: D003082:Colectomy / Q000379:methods*; D061887:Conversion to Open Surgery / Q000639:trends*; D004239:Diverticulitis, Colonic / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
keywords: Colectomy; Complication; Conversion; Diverticulitis; Elective; Laparoscopy