Is laparoscopic surgery applicable to complicated colonic diverticular disease?
| Autor: | J. P. Dorman, G. Plasencia, Morris E. Franklin, M. Jacobs |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Laparoscopic surgery
Adult Male medicine.medical_specialty medicine.medical_treatment Perforation (oil well) Diverticulum Colon Diverticulitis Colonic Postoperative Complications Colon surgery medicine Humans Laparoscopy Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test Rupture Spontaneous business.industry General surgery Diverticulitis Length of Stay Middle Aged medicine.disease Surgery Bowel obstruction Treatment Outcome Intestinal Perforation Diverticular disease Female Morbidity business Gastrointestinal Hemorrhage Abdominal surgery |
| Zdroj: | Surgical endoscopy. 11(10) |
| ISSN: | 0930-2794 |
| Popis: | Background: Expanding upon our experience with laparoscopic surgery for colonic benign and malignant processes and for bowel obstruction, we have reviewed our experience with minimal access laparoscopic surgery for complicated diverticular disease. We propose an approach of surgical care incorporating diagnostic laparoscopy in those not responding to medical therapy alone. Methods: Our study includes data from two different surgical teams working in separate hospital-and-patient environments. Our theory that laparoscopy could be widely applicable to this complex disease process is borne out by experience in both locations. One hundred forty-eight patients were managed by laparoscopic or laparoscopically assisted methods with 18 patients requiring drainage only without resection. Results: Our management of 148 of 164 patients (90%) by laparoscopic approach was successful, with a very acceptable morbidity of 5% in the elective cases and decreased ileus (20% of open vs 7% laparoscopic) in acute complicated cases. Elective resections required hospitalization of 4–5 days, demonstrating the benefits of incorporating laparoscopy in the care of these cases, particularly when compared to standard open procedures requiring 8 days' hospitalization. Conclusions: We believe complications of diverticular disease including abscess, perforation, fistula, and bleeding can potentially be managed in this way by minimal access procedures, decreasing postoperative wound problems, decreasing length of hospitalization and overall morbidity, and improving patient care. |
| Databáze: | OpenAIRE |
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