Abstract
Background
Laparoscopic sigmoid resection is a feasible and frequent operation for patients who suffer from recurrent diverticulitis. There is still an ongoing debate about the optimal timing for surgery in patients who suffer from recurrent diverticulitis episodes. In elective situations the complication rate for this procedure is moderate, but there are patients at high risk for perioperative complications. The few identified risk factors so far refer to open surgery. Data for the elective laparoscopic approach is rare. The objective of this study was to identify potential predictive risk factors for intra- and postoperative complications in patients who underwent laparoscopic sigmoid resection due to diverticular disease.
Methods
Uni- and multivariate analyses of a prospectively gathered database (1993–2006) were performed on a consecutive series of 526 patients who underwent laparoscopic sigmoid resection due to recurrent diverticulitis in a single institution. Patients were assessed for demographic data, operative indications, and intra- and postoperative complications. Altogether, we analyzed 17 potential risk factors to identify significant influence on the intra- and postoperative outcome, including timing of surgery.
Results
Statistical analysis of specific medical and surgical complications revealed anemia, previous myocardial infarction, heart failure, experience of the surgeon, and male gender, as independent predictive risk factors for postoperative complications. Patients older than age 75 years was the only independent risk factor for intraoperative complications in a multiple logistic regression model. Early elective surgery led to increased conversion rate but did not influence the postoperative complication rate.
Conclusions
This large, single-center study provides first evidence of the significance of specific predictive risk factors for intra- and postoperative complications in laparoscopic sigmoid resection for diverticular disease.
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Acknowledgments
Dr. Kirchhoff designed the study, analyzed the data, performed statistical analysis, and drafted the manuscript and had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Matz performed statistical analysis and drafted the manuscript. Dr. Dincler and Prof. Buchmann participated in the design and coordination of the study. All authors read and approved the final manuscript.
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Philipp Kirchhoff and Daniel Matz contribute equally to the work.
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Kirchhoff, P., Matz, D., Dincler, S. et al. Predictive Risk Factors for Intra- and Postoperative Complications in 526 Laparoscopic Sigmoid Resections due to Recurrent Diverticulitis: A Multivariate Analysis. World J Surg 35, 677–683 (2011). https://doi.org/10.1007/s00268-010-0889-2
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DOI: https://doi.org/10.1007/s00268-010-0889-2