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Sigmoid resection for diverticulitis is more difficult than for malignancies

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Sigmoid resection for diverticulitis is usually the first procedure performed when starting the learning process for laparoscopic colorectal surgery. The aim of this study is to evaluate the difficulty of laparoscopic sigmoid resection for diverticulitis in comparison to sigmoid malignancy in order to assess its role in the residents training program.

Methods

A cohort of patients was selected who suffered either from malignancy or recurrent diverticulitis in the sigmoid colon. Laparoscopic sigmoid resection was performed. The degree of difficulty was assessed by intraoperative complications and intraoperative technical challenges. Furthermore, take-overs from assistant to surgeon, surgeon to surgeon, and conversion were reported.

Results

A total of 224 patients were included, 119 (53.1%) men and 105 (46.9%) women.

Patients suffering from diverticulitis had significantly less co-morbidities than those with malignancies. In the diverticulitis group, there were significantly more technical challenges. There was a higher rate in take-overs from residents (p = 0.02) as well as surgeon to surgeon (p = 0.04). The rate of conversions was also significantly higher in the diverticulitis group (p = 0.03) when compared to the malignancy group.

Conclusions

The outcomes of our study show that diverticulitis may not be the ideal condition to start the learning process for laparoscopic colorectal surgery.

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Acknowledgements

The authors would like to thank the department of surgery and anesthesiology from the Meander Medical Center for their cooperation in this study.

Authors’ contribution

MAW Stam: Study design, data collection, data analysis and interpretation, and writing of the manuscript.

WA Draaisma: Study design, data interpretation, and writing of the manuscript.

PCM Pasker: Study design, data analysis, and data interpretation.

ECJ Consten: Study design, data interpretation, and writing of the manuscript.

IAMJ Broeders: Study design, data interpretation, and writing of the manuscript.

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Authors and Affiliations

  1. Department of surgery, Meander Medical Centre, PO box 1502, 3800 BM, Amersfoort, the Netherlands

    MAW Stam, WA Draaisma, PCM Pasker, ECJ Consten & IAMJ Broeders

Authors
  1. MAW Stam
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  2. WA Draaisma
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  3. PCM Pasker
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  4. ECJ Consten
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  5. IAMJ Broeders
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Corresponding author

Correspondence to MAW Stam.

Ethics declarations

The study was approved by the Meander Medical Centre ethical board. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

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Stam, M., Draaisma, W., Pasker, P. et al. Sigmoid resection for diverticulitis is more difficult than for malignancies. Int J Colorectal Dis 32, 891–896 (2017). https://doi.org/10.1007/s00384-017-2756-1

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  • DOI: https://doi.org/10.1007/s00384-017-2756-1

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