Laparoscopic resection for diverticular disease

作者: Christopher J. Bruce , John A. Coller , John J. Murray , David J. Schoetz , Patricia L. Roberts

DOI: 10.1007/BF02053798

关键词: Colorectal surgeryLaparotomyLaparoscopyLaparoscopic surgeryAnastomosisSurgeryGeneral surgeryDiverticulitisDiverticular diseaseMedicineBowel obstructionGastroenterologyGeneral Medicine

摘要: PURPOSE: The role of laparoscopic surgery in treatment patients with diverticulitis is unclear. A retrospective comparison conventional for chronic was performed to assess morbidity, recovery from surgery, and cost. METHODS: Records undergoing elective resection uncomplicated 1992 1994 at a single institution were reviewed. Laparoscopic involved complete intracorporeal dissection, bowel division, anastomosis extracorporeal placement an anvil. RESULTS: Sigmoid left colon resections laparoscopically 25 by open technique 17 two independent operating teams. No significant differences existed age, gender, weight, comorbidities, or operations performed. In the group, three converted laparotomy (12 percent) because unclear anatomy. Major complications occurred who underwent resection, both requiring laparotomy, one patient group computed tomographic-guided drainage abscess. Patients tolerated regular diet sooner than (3.2±0.9 vs. 5.7±1.1 days; P <0.001) discharged hospital earlier (4.2±1.1 vs. 6.8±1.1 days; P <0.001). Overall costs higher ($10,230±49.1 vs. $7,068±37.1; P <0.001) significantly longer total room time (397±9.1 vs. 115±5.1 min; P <0.001). Follow-up studies mean year revealed port site infections wound infection group. Of experienced postoperative obstruction that managed nonoperatively, and, patient, incarcerated incisional hernia developed required urgent laparotomy. CONCLUSIONS: safe, faster shorter stay compared surgery. Higher cost usage makes difficult justify economically. Simplification use better case selection may improve cost-effectiveness approach.

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