Cirugía laparoscópica electiva en enfermedad diverticular. Un estudio comparativo con la cirugía convencional / Elective laparoscopic surgery in diverticular disease. A comparative study with conventional operative surgery

ABSTRACT

BACKGROUND: Elective surgery in diverticular disease (DD) consists classically in performing an open sigmoidectomy. Laparoscopic surgery of the colon can have results that are comparable to those of open surgery. AIM: To compare the results of laparoscopic and conventional surgery for DD. MATERIALS AND METHODS: Retrospective review of preoperative, operative and postoperative variables of patients operated by laparoscopic surgery between the years 2000 and 20002. These results were compared with those of patients treated with conventional surgery in the same period. RESULTS: Thirty nine patients, mean age 59 years old, were operated via laparotomy and 18 patients, mean age 47 years old, were treated with laparoscopic surgery. Both groups were comparable in gender, amount of previous laparotomies, type of surgery performed and American Society of Anestesiologists classification. The operative time was significantly higher in the laparoscopic surgery group (230 v/s 130 min), but the opioid requirements, stay in an intensive surgical care ward, postoperative ileus and hospital stay were significantly shorter in the laparoscopic group. Eleven percent of the patients included in the laparoscopic group and 31 per cent of the patients treated with operative surgery had complications (p = 0.07). The length of the excised colon, the degree of inflammation and treatment costs were comparable. CONCLUSIONS: Laparoscopic surgery in DD is feasible, safe, requires less analgesia and allows a faster recovery of post-operative ileus and a lower hospital stay.