Our Summary

This study looks at the outcomes of a type of surgery called laparoscopic sigmoid colectomy, which was performed on patients with two different types of diverticulitis, a digestive disease. Diverticulitis can be either simple or complicated. The surgery was offered to all patients who needed an operation for this condition, between December 2001 and May 2013.

The researchers found that about a quarter of the patients had complicated diverticulitis. The surgery had to be converted to an open procedure in about 12.8% of all cases, and this rate was slightly lower for complicated cases. It took slightly longer for bowel function to return to normal in the complicated cases (3.8 days) compared to the simple cases (3.1 days). The length of hospital stay was similar for both groups.

The rate of a specific complication called anastomotic leak was 2.1%. The rate of postoperative complications was higher in the complicated diverticulitis group (19.6%) compared to the simple group (10.0%). For complicated patients who had to have the surgery converted to an open procedure, this complication rate was even higher (29.4%).

The researchers concluded that although having complicated diverticulitis didn’t increase the chance of needing to switch to an open procedure, these patients were more likely to have complications after surgery. However, they still recommend this laparoscopic approach, as long as it is performed by experienced surgeons.

FAQs

  1. What is laparoscopic sigmoid colectomy?
  2. What were the main findings of the study on patients with diverticulitis who underwent laparoscopic sigmoid colectomy?
  3. How does the rate of complications differ between simple and complicated diverticulitis cases after laparoscopic colectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic colectomy is to ensure they are being treated by an experienced surgeon. This can help reduce the risk of complications during and after the surgery. It is also important for patients to follow their surgeon’s post-operative instructions carefully to promote a smooth recovery process.

Suitable For

Patients with diverticulitis, both simple and complicated, are typically recommended for laparoscopic colectomy. However, this study suggests that patients with complicated diverticulitis may have a higher risk of postoperative complications compared to those with simple diverticulitis. It is important for these surgeries to be performed by experienced surgeons to minimize the risk of complications.

Timeline

  • Before laparoscopic colectomy:
  1. Patient is diagnosed with diverticulitis, either simple or complicated.
  2. Surgery is recommended as a treatment option.
  3. Patient undergoes preoperative evaluations and preparation for surgery.
  4. Surgery is scheduled and patient is informed of the procedure and potential risks.
  • During laparoscopic colectomy:
  1. Patient is prepared for surgery and anesthesia is administered.
  2. Surgeon makes small incisions in the abdomen and inserts a laparoscope to view the internal organs.
  3. Diseased portion of the colon is removed and the remaining ends are reconnected.
  4. Surgery may be converted to an open procedure if necessary.
  • After laparoscopic colectomy:
  1. Patient is monitored in the recovery room and then transferred to a hospital room.
  2. Pain management and monitoring of bowel function begin.
  3. Patient starts moving and walking to aid in recovery.
  4. Discharge planning begins once bowel function returns to normal.
  5. Patient is discharged from the hospital and instructed on postoperative care and follow-up appointments.
  6. Patient continues to recover at home and gradually resumes normal activities.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with laparoscopic colectomy for diverticulitis?
  2. How experienced is the surgical team in performing laparoscopic colectomy procedures?
  3. What is the success rate of laparoscopic colectomy for diverticulitis?
  4. What is the expected recovery time following laparoscopic colectomy?
  5. Are there any long-term effects or changes in bowel function after this procedure?
  6. Will I need to follow any special dietary or lifestyle guidelines after the surgery?
  7. How can I best prepare for the surgery, both physically and mentally?
  8. Are there any specific signs or symptoms I should watch for after the surgery that may indicate a complication?
  9. How soon after the surgery can I expect to resume normal activities and work?
  10. Are there any alternative treatment options for diverticulitis that I should consider before opting for surgery?

Reference

Authors: Bhakta A, Tafen M, Glotzer O, Canete J, Chismark AD, Valerian BT, Stain SC, Lee EC. Journal: Surg Endosc. 2016 Apr;30(4):1629-34. doi: 10.1007/s00464-015-4393-5. Epub 2015 Aug 15. PMID: 26275534