Our Summary

This research study evaluated two different surgical procedures used to treat a severe type of bowel disease called perforated diverticulitis. The two procedures are laparoscopic sigmoidectomy (LS), which is a minimally invasive surgery, and open sigmoidectomy (OS), a more traditional open surgery.

The researchers looked at patient data from 28 Dutch hospitals over four years. They compared patients who underwent LS with those who had OS, taking into account factors like age, gender, previous surgeries, disease severity, and the surgeon’s experience.

Their findings showed that patients who had LS had shorter hospital stays (7 days for LS versus 9 days for OS) and lower rates of post-surgery complications (44% for LS versus 66% for OS). The mortality rate was low for both procedures.

Additionally, the study found that patients who had LS had a higher chance of getting their bowel function back to normal after surgery (88% for LS versus 62% for OS at 12 months). For patients who had a different type of procedure called a primary anastomosis, the chance of getting their bowel function back to normal was 100% for both LS and OS.

In conclusion, the study suggests that the less invasive LS procedure may be a better option than OS for treating perforated diverticulitis, as it results in fewer complications and shorter hospital stays.

FAQs

  1. What are the two surgical procedures examined in the research study for treating perforated diverticulitis?
  2. According to the research study, which surgical procedure between LS and OS resulted in a shorter hospital stay and fewer post-surgery complications?
  3. Does the study suggest any difference in the chance of getting bowel function back to normal between patients who had LS and those who had OS?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to discuss the potential benefits of undergoing a laparoscopic sigmoidectomy (LS) versus an open sigmoidectomy (OS). LS is a minimally invasive surgery that has been shown to have shorter hospital stays, lower rates of post-surgery complications, and a higher chance of returning bowel function to normal compared to OS. Patients should talk to their doctor about which procedure may be the best option for their individual case.

Suitable For

Patients who are typically recommended sigmoidectomy are those with severe diverticulitis that has led to complications such as perforation, abscess formation, or fistula formation. These patients may have recurrent episodes of diverticulitis, have not responded to conservative treatments, or have a high risk of developing complications such as sepsis or bowel obstruction. Additionally, patients who are generally healthy enough to undergo surgery and are deemed suitable candidates for either laparoscopic or open sigmoidectomy may be recommended for this procedure.

Timeline

Before sigmoidectomy:

  1. Patient experiences symptoms of diverticulitis such as abdominal pain, bloating, and changes in bowel habits.
  2. Patient undergoes diagnostic tests such as a CT scan or colonoscopy to confirm the diagnosis.
  3. Patient may be treated with antibiotics or other non-surgical methods to manage the symptoms.
  4. If symptoms are severe or recurrent, patient may be recommended for sigmoidectomy surgery.

After sigmoidectomy:

  1. Patient undergoes pre-operative preparation including fasting and bowel preparation.
  2. Sigmoidectomy surgery is performed, either laparoscopically or through open surgery.
  3. Patient stays in the hospital for a few days for post-operative care and monitoring.
  4. Patient may experience pain, discomfort, and changes in bowel function after surgery.
  5. Patient gradually resumes normal activities and diet under the guidance of healthcare providers.
  6. Patient attends follow-up appointments to monitor recovery and address any concerns.
  7. Patient may experience improved bowel function and resolution of diverticulitis symptoms in the months following surgery.

What to Ask Your Doctor

  1. What is the purpose of a sigmoidectomy procedure?
  2. What are the potential risks and complications associated with sigmoidectomy?
  3. How long is the recovery period after a sigmoidectomy?
  4. Will I need to make any lifestyle changes after the surgery?
  5. How experienced is the surgeon in performing sigmoidectomy procedures?
  6. What type of anesthesia will be used during the surgery?
  7. What are the expected outcomes of the surgery in terms of bowel function and overall health?
  8. Will I need any additional treatments or medications after the surgery?
  9. How will the surgical incisions be closed, and what type of scarring can I expect?
  10. Are there any specific dietary restrictions or recommendations I should follow before or after the surgery?

Reference

Authors: Vennix S, Lips DJ, Di Saverio S, van Wagensveld BA, Brokelman WJ, Gerhards MF, van Geloven AA, van Dieren S, Lange JF, Bemelman WA. Journal: Surg Endosc. 2016 Sep;30(9):3889-96. doi: 10.1007/s00464-015-4694-8. Epub 2015 Dec 17. PMID: 26679173