Single-incision laparoscopic surgery for diverticulitis in overweight patients.
OBJECTIVE
Single-incision laparoscopic surgery (SILS) has been introduced as a new technique for the treatment of various colorectal diseases. Recurrent or complicated diverticulitis of the sigmoid colon is a frequent indication for minimally invasive sigmoid colectomy. The aim of this study was to investigate the impact of obesity on the outcome of SILS sigmoid colectomy.


METHODS
From September 2009 to October 2014, data from 377 patients who had intended SILS sigmoid colectomy for diverticulitis at our institution were collected in a prospective database. The patients were categorized in the following subgroups: group 1 (normal weight, body mass index (BMI) < 25 kg/m(2)), group 2 (overweight, BMI 25-29.9 kg/m(2)), group 3 (obesity, BMI 30-34.9 kg/m(2)), and group 4 (morbid obesity, BMI > 35 kg/m(2)).


RESULTS
The groups were equivalent for sex, age, status of diverticulitis, the presence of acute inflammation in the specimen, and the percentage of teaching operations, but the percentage of patients with accompanying diseases was significantly more frequent in groups 2, 3, and 4 (p = 0.04, 0.008, and 0.018, respectively). As compared to group 1, the conversion rate was significantly increased in groups 2 and 4 (2.3 vs. 9.3% (p = 0.013) and 2.3 vs. 12.5% (p = 0.017), respectively). The duration of surgery, hospitalization, and morbidity did not differ between the four groups.


CONCLUSIONS
Up to a body mass index of 35 kg/m(2), increased body weight does not significantly reduce the feasibility and outcome of single-incision laparoscopic surgery for diverticulitis.
Department of General, Visceral, and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany. andreas.rink@klinikum-lev.de.
Andreas D
AD
Rink
Department of General, Visceral, and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany.|King Edward VII Memorial Hospital, PO-Box HM 1023, Hamilton HM DX, Bermuda.
Boris
B
Vestweber
Department of General, Visceral, and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany.
Jasmina
J
Hahn
Department of General, Visceral, and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany.
Angelika
A
Alfes
Department of General, Visceral, and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany.
Claudia
C
Paul
Department of General, Visceral, and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany.
Karl-Heinz
KH
Vestweber
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D061887:Conversion to Open Surgery / Q000379:methods / Q000706:statistics & numerical data*; D016208:Databases, Factual; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D009765:Obesity / Q000601:surgery; D009767:Obesity, Morbid / Q000601:surgery; D050177:Overweight / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome
Obese; Overweight; Scarless; Single-access surgery; Single-site surgery; Umbilical incision