Resezioni coliche laparoscopiche per malattia diverticolare : risultati da un database prospettico

AIM OF STUDY: To evaluate the outcome of laparoscopic surgery in patients affected by colonic diverticulitis. MATERIALS AND METHODS: A prospective database was established in 1998 at our department to evaluate the results of laparoscopic treatment for diverticular disease. Contraindications to laparoscopic approach were: intestinal obstruction, faecal peritonitis, previuos major abdominal operations, presence of abdominal mass. Parameters evaluated were: indications to operation, age, sex, weight, type of operation, associated operations, operation time, conversion rate, mortality, post-operative complications, postoperative hospital stay, return to normal bowel function, time of removing nasogastric tube and time of restarting oral feeding. RESULTS: From 1998 to 2005, 109 patients operated for diverticular disease were registered. The operation was performed in 17 cases (15.5%) with open technique, in 20 cases (18.5%) throught video-assisted approach with extracorporeal anastomosis and in 72 cases (66%) with laparoscopic approach making intracorporeal anastomosis. The conversion rate was 10.8%. Mortality was 0%. In videolaparoscopic group mean operating time was 177 minutes, major complications were 4 (6.3%), minor complications were 6 (9.5%) and mean hospital stay was 7.8 days. In videoassisted group minor operation time was 158 minutes, complications were 9 (47.3%) and mean hospital stay was 10.1 days. CONCLUSIONS: Laparoscopic approach to diverticular disease of the colon is, in selected cases, a safe, feasible and effective procedure.