Elective laparoscopic sigmoid colectomy for diverticulitis - Results of a prospective study

Background: We undertook a prospective evaluation of elective laparoscopic sigmoid colectomy for diverticulitis in order to assess the risks and benef its of this approach. Methods: Between November 1992 and November 1996, 54 consecutive patients w ere included in this study. Their mean age was 59 +/- 13 years (range, 36-8 1). The number of at tacks of diverticulitis before colectomy ranged from o ne to four (mean, 2.2 +/- 0.7). The operative technique consisted of electi ve division of the inferior mesenteric vessels, left colonic flexure mobili zation, and colorectal anastomosis using the cross-stapling technique. Results: Five procedures (9.2%) were converted. The primary cause for conve rsion was obesity. These patients had a simple postoperative course. There were no postoperative deaths. Three patients (6.1%) developed abdominal com plications, and four patients (8.2%) had abdominal wall complications. Post operative paralytic ileus lasted only 2.3 +/- 0.7 days (range, 1-6), allowi ng for a rapid reintroduction of regular diet. The mean postoperative hospi tal stay was 6.4 +/- 2.7 days (range, 4-15). Conclusions: Elective laparoscopic colectomy for diverticulitis is feasible in most cases. In most cases, the operative risk is low and the postoperat ive course is uneventful. Elective sigmoid laparoscopic colectomy should be considered a good therapeutic option for symptomatic diverticulitis.