Abstract
Background:
Laparoscopic treatment of sigmoid diverticulitis is commonly accepted in Hinchey cases I and II, whereas it is debated in the case of purulent peritonitis, and not indicated for fecal peritonitis.
Methods:
A single-center experience of 103 patients treated for Hinchey I–III sigmoid diverticulitis was reviewed. One-stage laparoscopic resection and primary anastomosis constituted the planned procedure. Abscesses in patients with Hinchey IIa were drained percutaneously before surgery. Patients with Hinchey III underwent surgery in emergency. A four-trocar approach with left iliac fossa minilaparotomy was used. Fistulas were treated laparoscopically with Harmonic Scalpel dissection.
Results:
Laparoscopic treatment was successfully completed for 100 patients. Intraoperative complications occurred in 2.9% of the cases. Postoperative procedure-related morbidity was 8%, occurring mainly in Hinchey I patients. A longer hospital stay was recorded among Hinchey IIb patients treated for colovescical fistula. No mortality was observed.
Conclusions:
Laparoscopic surgery for sigmoid diverticulitis in experienced hands can be a safe and effective gold standard procedure also for patients with fistula or purulent peritonitis.
Similar content being viewed by others
References
P Ambrosetti (2002) ArticleTitleDiverticulite sigmoidienne: quand et à qui faut-il proposer une colectomie elective? Ann Chir 127 413–415
P Ambrosetti JM Michel JM Megevand PH Morel (1999) ArticleTitleLa colectomie gauche avec anastomose immediate dans la chirurgie d’urgence Ann Chir 53 1023–1028 Occurrence Handle1:STN:280:DC%2BD3c7jsFSnug%3D%3D Occurrence Handle10670152
C Belmonte JV Klas J Perez Javier W Douglas DA Rothemberger SM Goldberg (1996) ArticleTitleThe Hartmann procedure Arch Surg 131 612–617 Occurrence Handle1:STN:280:BymB2c%2FivFA%3D Occurrence Handle8645067
J Berthou PH Charbonneau (1997) ArticleTitleRésultats clu traitement laparoscopique de la sigmoidite diverticulaire: a propos de 85 cas Chirurgie 122 424–429
JL Bouillot JC Berthou G Champault C Meyer JP Arnaud G Samama D Collet P Bressler A Gainant B Delaitre (2002) ArticleTitleElective laparoscopic colonic resection for diverticular disease: results of a multicenter study in 179 patients Surg Endosc 16 1320–1323 Occurrence Handle10.1007/s00464-001-9236-x Occurrence Handle1:STN:280:DC%2BD38vntlGqtw%3D%3D Occurrence Handle11984674
JS Burgel F Navarro MC Lemoine J Michel JP Carbalona JM Fabre J Domergue (2000) ArticleTitleColectomie elective laparoscopique pour sigmoidite diverticulaire: etude prospective de 56 cas Ann Chir 125 231–237
RB Elliott S Yego TT Irvin (1997) ArticleTitleFive-year audit of the acute complications of diverticular disease Br J Surg 84 535–539
InstitutionalAuthorNameEuropean Association for Endoscopic Surgery Consensus Conference (1999) ArticleTitleDiagnosis and treatment of diverticular disease Surg Endosc 13 430–436
ME Franklin SuffixJr JP Dorman M Jacobs G Plasencia (1997) ArticleTitleIs laparoscopic surgery applicable to complicated colonic diverticular disease? Surg Endosc 11 1021–1025 Occurrence Handle10.1007/s004649900516 Occurrence Handle9381341
JM Greif G Fried CK McSherry (1980) ArticleTitleSurgical treatment of perforated diverticulitis of the sigmoid colon Dis Colon Rectum 23 483–487
U Hildebrandt K Kessler T Plusczyk G Pistorius B Vollmar MD Menger (2003) ArticleTitleComparison of surgical stress between laparoscopic and open colonic resection Surg Endosc 17 242–246
EJ Hinchey PG Schaal GK Richards (1978) ArticleTitleTreatment of perforated diverticular disease of the colon Adv Surg 12 85–109 Occurrence Handle1:STN:280:CSaC3c%2FotlE%3D Occurrence Handle735943
F Kockerling C Schneider MA Reymond H Scheidbach H Scheuerlein J Konradt HP Bruch C Zornig L Kohler E Barlehner A Kuthe G Szinicz HA Richer W Hohenberger (1999) ArticleTitleLaparoscopic resection of sigmoid diverticulitis: results of a multicenter study Laparoscopic Colorectal Surgery Study Group. Surg Endosc 13 567–571 Occurrence Handle1:STN:280:DyaK1M3nvVGgug%3D%3D
TG Parks (1969) ArticleTitleNatural history of diverticular disease of the colon: a review of 521 cases BMJ 4 639–645 Occurrence Handle1:STN:280:CS%2BD28zgsFA%3D Occurrence Handle5359917
DA Rothemberger O Wiltz (1993) ArticleTitleSurgery for complicated diverticulitis Surg Clin North Am 73 975–992
ME Sher F Agachan M Bortul JJ Nogueras EJ Weiss SD Wexner (1997) ArticleTitleLaparoscopic surgery for diverticulitis Surg Endosc 11 264–267 Occurrence Handle10.1007/s004649900340 Occurrence Handle1:STN:280:ByiB3snntlA%3D Occurrence Handle9079606
ARL Stevenson RW Stitz JW Lumley GA Fielding (1998) ArticleTitleLaparoscopically assisted anterior resection for diverticular disease: follow-up of 100 consecutive patients Ann Surg 227 335–342 Occurrence Handle10.1097/00000658-199803000-00004 Occurrence Handle1:STN:280:DyaK1c7os1artg%3D%3D Occurrence Handle9527055
HN Stolmann JB Raskin (1999) ArticleTitleDiagnosis and management of diverticular disease of the colon in the adults Am J Gastroenterol 94 3110–3121 Occurrence Handle10.1016/S0002-9270(99)00560-2 Occurrence Handle1:STN:280:DC%2BD3c%2FjtV2ktA%3D%3D Occurrence Handle10566700
InstitutionalAuthorNameThe Standards Task Force American Society of Colon, and Rectal Surgeons (1995) ArticleTitlePractice parameters for sigmoid diverticulitis Dis Colon Rectum 38 125–132
G Trebuchet D Lechaux JL Lecalve (2002) ArticleTitleLaparoscopic left colon resection for diverticular disease: results from 170 consecutive cases Surg Endosc 16 18–21 Occurrence Handle10.1007/s004640090122 Occurrence Handle1:STN:280:DC%2BD383isFGisw%3D%3D Occurrence Handle11961597
JJ Tuech N Regenet S Hennekinne P Pessaux R Bergamaschi JP Arnaud (2001) ArticleTitleLaparoscopic colectomy for sigmoid diverticulitis in obese and nonobese patients Surg Endosc 15 1427–1430 Occurrence Handle1:STN:280:DC%2BD383ivVSktw%3D%3D Occurrence Handle11965459
TW Umbach RA Dorazio (1999) ArticleTitlePrimary resection and anastomosis for perforated left colon lesions Am J Surg 65 932–933
J Wedell G Banzhaf R Fisher J Reichmann (1997) ArticleTitleSurgical management of complicated colonic diverticulitis Br J Surg 84 380–383
RJ Woods IC Lavery VW Fazio DG Jagelmann FL Weakley (1988) ArticleTitleInternal fistulas in diverticular disease Dis Colon Rectum 31 591–596
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pugliese, R., Di Lernia, S., Sansonna, F. et al. Laparoscopic treatment of sigmoid diverticulitis: a retrospective review of 103 cases. Surg Endosc 18, 1344–1348 (2004). https://doi.org/10.1007/s00464-003-9178-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-003-9178-6