title: Effectiveness of elective laparoscopic treatment for colonic diverticulitis.
abstract: OBJECTIVE
  To analyze the short- and long-term outcomes of laparoscopic sigmoid colectomy for the elective treatment of diverticular disease.
  
  
  METHODS
  A consecutive unselected series of 94 patients undergoing elective laparoscopic sigmoid colectomy for diverticular disease from 2008 to 2012 was analyzed. We collected patients-, surgery- and hospital stay-related data, as well as the short- and long-term outcomes. Operative steps, instrumentation, and postoperative cares were standardized. Comorbidity was assessed by Charlson comorbidity index. Complications were classified using the Clavien-Dindo classification system. The qualitative long-term assessment was carried out by subjecting patients to the validated gastrointestinal quality of life index questionnaire before and after surgery.
  
  
  RESULTS
  The mean age of our cohort was 61.3 ± 11.0 years with a Charlson comorbidity index of 1.2 ± 1.5. Mean operative time was 213.5 ± 60.8 minutes and estimated blood loss was 67.2 ± 94.3 mL. We had 3 cases (3.2%) of conversion to open laparotomy. The rates of postoperative complications were 35.1%, 6.3%, 2.1%, and 1.06%, respectively, for grades 1, 2, 3b, and 5 according to the Clavien-Dindo system. Length of hospital stay was 8.1 ± 1.9 days, and we have not recorded readmissions in patients discharged within 60 days after surgery. Median follow-up was of 9.6 ± 2.7 months. We observed no recurrence of diverticular disease, but there was evidence of 3 cases of incisional hernia (3.19%). The difference between preoperative and late gastrointestinal quality of life index score was statistically significant (97.1 ± 5.8 vs 129.6 ± 8.0).
  
  
  CONCLUSIONS
  Elective laparoscopic treatment of colonic diverticular disease represents an effective option that produces adequate postoperative results and ensures a satisfactory functional outcome.
authors.affiliation: Division of General Surgery, Department of Surgery, Galmarini Hospital, Tradate, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Roscio
authors.affiliation: Division of General Surgery, Department of Surgery, Galmarini Hospital, Tradate, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Grillone
authors.affiliation: Division of General Surgery, Department of Surgery, Galmarini Hospital, Tradate, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Frattini
authors.affiliation: Division of General Surgery, Department of Surgery, Galmarini Hospital, Tradate, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: De Luca
authors.affiliation: Division of General Surgery, Department of Surgery, Galmarini Hospital, Tradate, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Girardi
authors.affiliation: Division of General Surgery, Department of Surgery, Galmarini Hospital, Tradate, Italy.
authors.forename: Ildo
authors.initials: I
authors.lastname: Scandroglio
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D003082:Colectomy; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D004239:Diverticulitis, Colonic / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011788:Quality of Life; D012189:Retrospective Studies
keywords: Diverticular disease; Elective surgery; Laparoscopic surgery; Sigmoid colectomy