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Laparoscopic resection of chronic sigmoid diverticulitis with fistula.
JSLS. 2013 Oct-Dec; 17(4):636-40.JSLS

Abstract

BACKGROUND AND OBJECTIVES

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.

Links

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Authors+Show Affiliations

Abbass MA
Department of Surgery, Kaiser Permanente, Los Angeles, CA, USA.
Tsay AT
Department of Surgery, Kaiser Permanente, Los Angeles, CA, USA.
Abbas MA
Chair, Minimally Invasive and Robotic Surgery, 4760 Sunset Boulevard, Third Floor, Los Angeles, CA 90027, USA. maher.a.abbas@kp.org.

MeSH

AdultAgedAged, 80 and overChronic DiseaseColonic DiseasesDigestive System Surgical ProceduresDiverticulitisHumansIntestinal FistulaLaparoscopyMiddle AgedRetrospective StudiesSigmoid Diseases

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24398208

Citation

Abbass, Mohammad A., et al. "Laparoscopic Resection of Chronic Sigmoid Diverticulitis With Fistula." JSLS : Journal of the Society of Laparoendoscopic Surgeons, vol. 17, no. 4, 2013, pp. 636-40.
Abbass MA, Tsay AT, Abbas MA. Laparoscopic resection of chronic sigmoid diverticulitis with fistula. JSLS. 2013;17(4):636-40.
Abbass, M. A., Tsay, A. T., & Abbas, M. A. (2013). Laparoscopic resection of chronic sigmoid diverticulitis with fistula. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 17(4), 636-40. https://doi.org/10.4293/108680813X13693422520512
Abbass MA, Tsay AT, Abbas MA. Laparoscopic Resection of Chronic Sigmoid Diverticulitis With Fistula. JSLS. 2013 Oct-Dec;17(4):636-40. PubMed PMID: 24398208.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic resection of chronic sigmoid diverticulitis with fistula. AU - Abbass,Mohammad A, AU - Tsay,Anna T, AU - Abbas,Maher A, PY - 2014/1/9/entrez PY - 2014/1/9/pubmed PY - 2014/9/24/medline SP - 636 EP - 40 JF - JSLS : Journal of the Society of Laparoendoscopic Surgeons JO - JSLS VL - 17 IS - 4 N2 - BACKGROUND AND OBJECTIVES: 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. SN - 1938-3797 UR - https://www.unboundmedicine.com/medline/citation/24398208/Laparoscopic_resection_of_chronic_sigmoid_diverticulitis_with_fistula_ DB - PRIME DP - Unbound Medicine ER -