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Laparoscopic Sigmoidectomy for Fistulized Diverticulitis

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Diseases of the Colon & Rectum

PURPOSE

Nowadays laparoscopic colorectal surgery has demonstrated its advantages, including reduced postoperative pain, decreased duration of ileus, and shorter hospital stay. Few studies report results of laparoscopic surgery in complicated diverticulitis. This study was designed to analyze the results of laparoscopic sigmoidectomy in patients with fistulized sigmoiditis.

METHODS

The authors retrospectively reviewed 16 patients who had laparoscopic sigmoidectomy for fistulized diverticulitis between 1992 and 2003 in a series of 247 laparoscopic colectomies. Eleven patients presented with colovesical, four with colovaginal, and one with colocutaneous fistulas; all were caused by sigmoiditis. The procedure always consisted of celioscopic sigmoidectomy with stapled transanal suture and, when indicated, closure of the cystic or vaginal fistula orifice.

RESULTS

Mean age was 60 (range, 39–78) years. Mean number of episodes of diverticulitis before operation was three (range, 1–5). Mean time between the last episode and operation was 46 (range, 2–250) weeks. In our first three years of experience, three cases (18.7 percent) were converted to laparotomy. Reasons for conversion were the necessity for intestinal resection, splenectomy, and a wound of the anterior rectum. The mean operative time was 172 (range, 100–280) minutes. Mean hospital stay was 5.7 (range, 3–12) days. There was no mortality. Postoperative morbidity (2 patients, 12.5 percent) consisted of one pulmonary infection and one splenectomy. Long-term follow-up revealed no recurrence of diverticulitis and one incisional hernia.

CONCLUSIONS

In experienced hands, laparoscopic sigmoidectomy may be a safe and effective procedure for fistulized sigmoiditis.

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REFERENCES

  1. DB Redwine DR Sharpe (1991) ArticleTitleLaparoscopic segmental resection of the sigmoid colon for endometriosis J Laparoendosc Surg 1 217–20 Occurrence Handle1:STN:280:By2D3szitFE%3D Occurrence Handle1834272

    CAS  PubMed  Google Scholar 

  2. SD Wexner OB Johansen JJ Nogueras DG Jagelman (1992) ArticleTitleLaparoscopic total abdominal colectomy: a prospective trial Dis Colon Rectum 35 651–5 Occurrence Handle1:STN:280:By2A3cnnslc%3D Occurrence Handle1535308

    CAS  PubMed  Google Scholar 

  3. HH Chen SD Wexner EG Weiss et al. (1998) ArticleTitleLaparoscopic colectomy for benign colorectal disease is associated with a significant reduction in disability as compared with laparotomy Surg Endosc 12 1397–400 Occurrence Handle10.1007/s004649900867 Occurrence Handle1:STN:280:DyaK1M%2FktVWhsw%3D%3D Occurrence Handle9822465

    Article  CAS  PubMed  Google Scholar 

  4. JW Fleshman H Nelson WR Peters et al. (1996) ArticleTitleEarly results of laparoscopic surgery for colorectal cancer. Retrospective analysis of 372 patients treated by Clinical Outcomes of Surgical Therapy (COST) Study Group Dis Colon Rectum 39 S53–8 Occurrence Handle1:STN:280:BymH38fksVA%3D Occurrence Handle8831547

    CAS  PubMed  Google Scholar 

  5. F Agachan JS Joo EG Weiss SD Wexner (1996) ArticleTitleIntraoperative laparoscopic complications. Are we getting better? Dis Colon Rectum 39 (Suppl 10) S14–9

    Google Scholar 

  6. JW Lumley GA Fielding M Rhodes LK Nathanson S Siu RW Stitz (1996) ArticleTitleLaparoscopic-assisted colorectal surgery: lessons learned from 240 consecutive patients Dis Colon Rectum 39 155–9 Occurrence Handle1:STN:280:BymB38znt1M%3D Occurrence Handle8620781

    CAS  PubMed  Google Scholar 

  7. PM Falk RW Beart SuffixJr SD Wexner et al. (1993) ArticleTitleLaparoscopic colectomy: a critical appraisal Dis Colon Rectum 36 28–34 Occurrence Handle1:STN:280:ByyC3crntlw%3D Occurrence Handle8416776

    CAS  PubMed  Google Scholar 

  8. CL Garrard RH Clements L Nanney JM Davidson WO Richards (1999) ArticleTitleAdhesion formation is reduced after laparoscopic surgery Surg Endosc 13 10–3 Occurrence Handle10.1007/s004649900887 Occurrence Handle1:STN:280:DyaK1M%2FovVaqsQ%3D%3D Occurrence Handle9869679

    Article  CAS  PubMed  Google Scholar 

  9. E Schippers A Tittel A Ottinger V Schumpelick (1998) ArticleTitleLaparoscopy versus laparotomy: comparison of adhesion-formation after bowel resection in a canine model Dig Surg 15 145–7 Occurrence Handle10.1159/000018608 Occurrence Handle1:STN:280:DyaK1M%2Fmt1Witg%3D%3D Occurrence Handle9845577

    Article  CAS  PubMed  Google Scholar 

  10. DJ Hackam OD Rotstein (1998) ArticleTitleHost response to laparoscopic surgery: mechanisms and clinical correlates Can J Surg 41 103–11

    Google Scholar 

  11. L Kohler D Rixen H Troidl (1998) ArticleTitleLaparoscopic colorectal resection for diverticulitis Int J Colorectal Dis 13 43–7 Occurrence Handle10.1007/s003840050130 Occurrence Handle9548100

    Article  PubMed  Google Scholar 

  12. L Krahenbuhl M Schafer V Kuzinkovas et al. (1998) ArticleTitleExperimental study of adhesion formation in open and laparoscopic fundoplication Br J Surg 85 826–30

    Google Scholar 

  13. C Huscher G Silecchia E Croce et al. (1996) ArticleTitleLaparoscopic colorectal resection. A multicenter Italian study Surg Endosc 10 875–9 Occurrence Handle10.1007/s004649900187 Occurrence Handle1:STN:280:ByiC2cjovFw%3D Occurrence Handle8703141

    Article  CAS  PubMed  Google Scholar 

  14. GH Ballantyne (1995) ArticleTitleLaparoscopic-assisted colorectal surgery: review of results in 752 patients Gastroenterologist 3 75–89 Occurrence Handle1:STN:280:ByqB287mvFI%3D Occurrence Handle7743123

    CAS  PubMed  Google Scholar 

  15. JM Ramos RW Beart SuffixJr R Goes AE Ortega RT Schlinkert (1995) ArticleTitleRole of laparoscopy in colorectal surgery: a prospective evaluation of 200 cases Dis Colon Rectum 38 494–501 Occurrence Handle1:STN:280:ByqB2MvpslY%3D Occurrence Handle7736880

    CAS  PubMed  Google Scholar 

  16. AJ Senagore HJ Duepree CP Delaney et al. (2002) ArticleTitleCost structure of laparoscopic and open sigmoid colectomy for diverticular disease: similarities and differences Dis Colon Rectum 45 485–90 Occurrence Handle10.1007/s10350-004-6225-x Occurrence Handle12006930

    Article  PubMed  Google Scholar 

  17. DM Lauter EJ Froines (2001) ArticleTitleInitial experience with 150 cases of laparoscopic assisted colectomy Am J Surg 181 398–403

    Google Scholar 

  18. C Smadja IM Sbai M Tahrat et al. (1999) ArticleTitleElective laparoscopic sigmoid colectomy for diverticulitis. Results of a prospective study Surg Endosc 13 645–8 Occurrence Handle10.1007/s004649901065 Occurrence Handle1:STN:280:DyaK1Mzhs1eruw%3D%3D Occurrence Handle10384067

    Article  CAS  PubMed  Google Scholar 

  19. JC Berthou P Charbonneau (1999) ArticleTitleElective laparoscopic management of sigmoid diverticulitis. Results in a series of 110 patients Surg Endosc 13 457–60 Occurrence Handle10.1007/s004649901012 Occurrence Handle1:STN:280:DyaK1M3ksVOntA%3D%3D Occurrence Handle10227941

    Article  CAS  PubMed  Google Scholar 

  20. F Kockerling C Schneider MA Reymond et al. (1999) ArticleTitleLaparoscopic resection of sigmoid diverticulitis. Results of a multicenter study Laparoscopic Colorectal Surgery Study Group. Surg Endosc 13 567–71 Occurrence Handle1:STN:280:DyaK1M3nvVGgug%3D%3D

    CAS  Google Scholar 

  21. JS Joo F Agachan SD Wexner (1997) ArticleTitleLaparoscopic surgery for lower gastrointestinal fistulas Surg Endosc 11 116–8 Occurrence Handle10.1007/s004649900310 Occurrence Handle1:STN:280:ByiB383kvFI%3D Occurrence Handle9069139

    Article  CAS  PubMed  Google Scholar 

  22. F Siriser (1999) ArticleTitleLaparoscopic-assisted colectomy for diverticular sigmoiditis. A single-surgeon prospective study of 65 patients Surg Endosc 13 811–3 Occurrence Handle10.1007/s004649901106 Occurrence Handle10430692

    Article  PubMed  Google Scholar 

  23. L Horner (1958) ArticleTitleNatural history of diverticular disease of the colon Am J Dig Dis 3 343–50 Occurrence Handle1:STN:280:CyeD28zltlw%3D Occurrence Handle13520671

    CAS  PubMed  Google Scholar 

  24. DM Larson SS Masters HM Spiro (1976) ArticleTitleMedical and surgical therapy in diverticular disease: a comparative study Gastroenterology 71 734–7

    Google Scholar 

  25. L Kohler S Sauerland E Neugebauer (1999) ArticleTitleDiagnosis and treatment of diverticular disease: results of a consensus development conference. The Scientific Committee of the European Association for Endoscopic Surgery Surg Endosc 13 430–6 Occurrence Handle1:STN:280:DyaK1M7psVyqtw%3D%3D Occurrence Handle10094765

    CAS  PubMed  Google Scholar 

  26. P Roberts M Abel L Rosen et al. (1995) ArticleTitlePractice parameters for sigmoid diverticulitis. The Standards Task Force American Society of Colon and Rectal Surgeons Dis Colon Rectum 38 125–32 Occurrence Handle1:STN:280:ByqC2Mvgs1U%3D Occurrence Handle7851165

    CAS  PubMed  Google Scholar 

  27. PL Benn BG Wolff DM Ilstrup (1986) ArticleTitleLevel of anastomosis and recurrent colonic diverticulitis Am J Surg 151 269–71

    Google Scholar 

  28. A Dwivedi F Chahin S Agrawal et al. (2002) ArticleTitleLaparoscopic colectomy vs. open colectomy for sigmoid diverticular disease Dis Colon Rectum 45 1309–14 Occurrence Handle12394427

    PubMed  Google Scholar 

  29. JL Bouillot JC Berthou G Champault et al. (2002) ArticleTitleElective laparoscopic colonic resection for diverticular disease: results of a multicenter study in 179 patients Surg Endosc 16 1320–3 Occurrence Handle10.1007/s00464-001-9236-x Occurrence Handle1:STN:280:DC%2BD38vntlGqtw%3D%3D Occurrence Handle11984674

    Article  CAS  PubMed  Google Scholar 

  30. MC Moine ParticleLe C Vacher R Spinelli et al. (2002) ArticleTitleLaparoscopic sigmoid resection for diverticula disease: a monocenter prospective study of 156 patients Surg Endosc 16 (Suppl 1) S27

    Google Scholar 

  31. MA Liberman EH Phillips BJ Carroll M Fallas R Rosenthal (1996) ArticleTitleLaparoscopic colectomy vs traditional colectomy for diverticulitis. Outcome and costs Surg Endosc 10 15–8 Occurrence Handle10.1007/s004649910002 Occurrence Handle1:STN:280:BymB28znslE%3D Occurrence Handle8711597

    Article  CAS  PubMed  Google Scholar 

  32. CM Schlachta J Mamazza EC Poulin (1999) ArticleTitleLaparoscopic sigmoid resection for acute and chronic diverticulitis. An outcomes comparison with laparoscopic resection for nondiverticular disease Surg Endosc 13 649–53 Occurrence Handle10.1007/s004649901066 Occurrence Handle1:STN:280:DyaK1Mzhs1eqsg%3D%3D Occurrence Handle10384068

    Article  CAS  PubMed  Google Scholar 

  33. JJ Tuech N Regenet S Hennekinne et al. (2001) ArticleTitleImpact of obesity on postoperative results of elective laparoscopic colectomy in sigmoid diverticulitis: a prospective study [in French] Ann Chir 126 996–1000 Occurrence Handle10.1016/S0003-3944(01)00638-1 Occurrence Handle1:STN:280:DC%2BD38%2FnslylsA%3D%3D Occurrence Handle11803638

    Article  CAS  PubMed  Google Scholar 

  34. AJ Senagore HJ Duepree CP Delaney KM Brady VW Fazio (2003) ArticleTitleResults of a standardized technique and postoperative care plan for laparoscopic sigmoid colectomy: a 30-month experience Dis Colon Rectum 46 503–9 Occurrence Handle10.1007/s10350-004-6590-5 Occurrence Handle12682545

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Abdominal Surgery, CHU Sart Tilman B35, Liège, Belgium

    S. R. Laurent M.D., B. Detroz M.D., O. Detry M.D., C. Degauque M.D., P. Honoré M.D. & M. Meurisse M.D.

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  1. S. R. Laurent M.D.
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  2. B. Detroz M.D.
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  3. O. Detry M.D.
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  4. C. Degauque M.D.
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  5. P. Honoré M.D.
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  6. M. Meurisse M.D.
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Laurent, S., Detroz, B., Detry, O. et al. Laparoscopic Sigmoidectomy for Fistulized Diverticulitis. Dis Colon Rectum 48, 148–152 (2005). https://doi.org/10.1007/s10350-004-0745-2

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