Laparoscopic sigmoidectomy for complicated diverticular disease

Asem Ghasoup, MD, FACS1, Turki Al Qurashi, MD1, Mohammed Widinly, MD1, Omar Sadieh, MD, FACS2. 1Security Forces Hospital Makkah, 2Saad Specialty Hospital

Background: Laparoscopic colo-rectal surgery has shown its advantages in terms of reduced post-operative pain, earlier recovery of intestinal peristalsis and shorter hospital stay.

Few studies reported results of laparoscopic surgery in complicated diverticulitis. The aim of this study to analyze the results of laparoscopic sigmoidectomy in patients with fistulized sigmoiditis.

Methods: we reviewed 8 patients operated on for fistulized sigmoidectomy between January 2010  to December 2014, in a series of 60 laparoscopic colectomies. five patients presented with colo-vesical fistula, two with colo-cutaneous fistula  and one with complicatged colo-cutaneous and coli-vesical fistula and all were caused by sigmoiditis. The procedure always consisted in laparoscopic  sigmoidectomy with stapled transanal suture and eventually closure of the cystic orifice.

Results: Mean age was 54 years (range: 39 to 70 years). Mean number of diverticulitis crises before operation was 3 (range: 1 to 5). Mean time between the last crisis and operation was 32 weeks (range: 2 to 120 weeks).The mean operating time was 120 min (range: 90 to 180 min). Mean hospitalization stay was 5.7 days (3-12 days). Mortality rate was 0%. Postoperative morbidity (0%). Long-term follow-up demonstrated no diverticultis recurrence.

Conclusion: laparoscopic sigmoidectomy may be a safe and effective procedure for fistulized diverticular sigmoiditis if it is done by a trained surgeon.

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