Laparoscopic-assisted colectomy for diverticular sigmoiditis. A single-surgeon prospective study of 65 patients.

BACKGROUND: The feasibility of laparoscopic colectomy has now been established, but little attention has been paid to its indications. Therefore, we undertook a prospective study of the laparoscopic treatment of diverticular disease of the colon.

METHODS: A total of 65 patients were operated on by a single surgeon between July 1993 and March 1998. Indications for operation included a previous acute attack of diverticulitis, abscess, or colovesical fistula. All procedures were laparoscopic-assisted.

RESULTS: Three conversions (4. 6%) were necessary. There were no postoperative mortalities. Nine postoperative complications occurred (17%); one of them (1.5%) was directly related to the operation and required reoperation. Patients passed flatus after 2.2 +/- 1.2 days (range, 1-9), and oral feeding was started after 2.6 +/- 1.3 days (range, 1-9). The hospital stay was 7.6 +/- 3 days (range, 5-19). No patient with >6 months of follow-up (40 patients) had any complaints related to diverticular disease.

CONCLUSIONS: These results suggest that this procedure is as safe as the traditional approach and provides superior comfort and cosmesis with the same long-term outcome.