title: Laparoscopic versus Open Surgery for Diverticulitis: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  The study aimed to perform a meta-analysis comparing laparoscopic and open surgery for diverticulitis.
  
  
  METHODS
  Studies comparing the outcomes of laparoscopic surgery versus open surgery for diverticulitis that reported quantitative data were included. Outcome measures were mortality and morbidity rates and length of hospital stay.
  
  
  RESULTS
  Four randomized controlled trials - 3 prospective and 21 retrospective - were included in the analysis. The total numbers of patients ranged from 5 to 14,562 in the laparoscopic groups and from 4 to 110,172 in the open surgery groups, and the mean patient age ranged from 38.9 to 78 years. Overall analysis revealed that laparoscopic surgery was associated with lower mortality (pooled OR 0.40, 95% CI 0.25-0.63, p < 0.001) and a lower overall morbidity rate (pooled OR 0.65, 95% CI 0.51-0.82, p < 0.001) than open surgery. Laparoscopic surgery was associated with a higher anastomotic bleeding rate, but lower rates of ileus, anastomotic leakage, small bowel obstruction, wound infection, fascial dehiscence and intra-abdominal abscesses. Length of hospital stay was less with laparoscopic surgery.
  
  
  CONCLUSIONS
  The current meta-analysis supports the use of laparoscopy for the treatment of diverticulitis. The results, however, should be interpreted with caution.
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Kuen-Lin
authors.initials: KL
authors.lastname: Wu
authors.forename: Ko-Chao
authors.initials: KC
authors.lastname: Lee
authors.forename: Chia-Cheng
authors.initials: CC
authors.lastname: Liu
authors.forename: Hong-Hwa
authors.initials: HH
authors.lastname: Chen
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Lu
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000209:etiology; D003082:Colectomy / Q000379:methods* / Q000401:mortality; D003106:Colon / Q000601:surgery*; D004239:Diverticulitis, Colonic / Q000401:mortality / Q000601:surgery*; D006801:Humans; D045823:Ileus / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects* / Q000401:mortality; D007902:Length of Stay; D011183:Postoperative Complications / Q000209:etiology*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology
keywords: Colectomy; Diverticulitis; Laparoscopy; Meta-analysis