Use and outcomes of emergent laparoscopic resection for acute diverticulitis

• Published in: The American journal of surgery Vol. 203; no. 5; pp. 639 - 643
• Main Authors: Rea, Jennifer D., M.D, Herzig, Daniel O., M.D, Diggs, Brian S., Ph.D, Cone, Molly M., M.D, Lu, Kim C., M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2012; Elsevier; Elsevier Limited
• Subjects: Acute; Acute Disease; Adolescent; Adult; Aged; Biological and medical sciences; Colectomy; Colon resection; Digestive system. Abdomen; Diverticulitis; Diverticulitis, Colonic - surgery; Endoscopy; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Hospitalization; Hospitals; Humans; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy; Medical sciences; Medicare; Middle Aged; Mortality; Ostomy; Other diseases. Semiology; Sigmoidectomy; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Treatment Outcome; Young Adult; Canada; United States > US; Sigmoidectomy; Laparoscopy; Colectomy; Diverticulitis; Acute; Colon resection; Endoscopic surgery; Prognosis; Digestive system; Use; Gut; Diverticulifis; Medicine; Treatment; Digestive diseases; Intestinal disease; Evolution; Colon; Endoscopy
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2012.01.004

Abstract Background The use and outcomes of laparoscopic sigmoid resection during emergency admissions for diverticulitis are unknown. Methods The Nationwide Inpatient Sample was queried for colorectal resections performed for diverticulitis during emergent hospital admissions (2003–2007). Univariate and multivariate analyses including patient, hospital, and outcome variables were performed. Results A national estimate of 67,645 resections (4% laparoscopic) was evaluated. The rate of conversion to open operation was 55%. Ostomies were created in 66% of patients, 67% open and 41% laparoscopic. Laparoscopy was not a predictor of mortality (odds ratio [OR] =.70; confidence interval [CI], .32–1.53). Laparoscopy predicted routine discharge (OR = 1.31; CI, 1.06–1.63) and a decreased length of stay (absolute days = −.78; CI, −1.19 to −.37). There was no difference in the cost of hospitalization between the 2 groups ( P = .45). Conclusions In acute diverticulitis, urgent laparoscopic resection decreases the length of stay. However, it is associated with a high conversion rate, no cost savings, and no difference in mortality.