Two-stage totally minimally invasive approach for acute complicated diverticulitis.
Colorectal Dis
; 8(6): 501-5, 2006 Jul.
Article
de En
| MEDLINE
| ID: mdl-16784471
ABSTRACT
OBJECTIVES:
Surgical options for acute diverticulitis with peritonitis include Hartmann's procedure or resection and primary anastomosis with or without a stoma. Initial laparoscopic lavage and drainage can control the acute intra-abdominal sepsis to allow for a delayed definitive procedure in nonemergency conditions. Potential advantages include the avoidance of a laparotomy, stoma and local infections at the origin of dehiscence and incisional hernias. We evaluated this approach in a selected group of patients.METHODS:
Patients with intra-abdominal pus secondary to diverticular perforation requiring surgery were included in the study. Patients with localized pus amenable to computerized tomography (CT)-guided drainage, faecal peritonitis, severe generalized peritonitis, and those in which the perforation was spontaneously visible were excluded. Standard demographic data, CT findings, intra-operative findings and postoperative outcomes were analysed.RESULTS:
Ten patients were suitable for the approach. Mean patient age was 60.2 years. Mean body mass index was 28.2 m2/kg. Mean postoperative stay was 8.5 days and uneventful in all patients. One patient re-presented after 3 weeks with acute peritonitis requiring open sigmoidectomy. Six patients successfully underwent laparoscopic sigmoidectomy with primary anastomosis 2-3 months later. Two patients were not re-operated because of comorbidity and one refused surgery.CONCLUSIONS:
A two-stage totally minimally invasive approach may be a safe alternative strategy for selected cases of acute complicated diverticulitis.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Procédures de chirurgie digestive
/
Diverticulite colique
Type d'étude:
Observational_studies
/
Risk_factors_studies
Limites:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Langue:
En
Journal:
Colorectal Dis
Sujet du journal:
GASTROENTEROLOGIA
Année:
2006
Type de document:
Article
Pays d'affiliation:
France