Results of elective laparoscopic partial colectomy for complicated diverticular disease

Objectives - To analyze a unicentric series of 100 consecutive elective lap aroscopic colon resections for diverticular disease and to evaluate in inte ntion to treat the early- and middle-term postoperative results. Methods-From February 1993 to March 1998, 100 colon resections for complica ted diverticular disease were performed through laparoscopy with systematic mobilization of splenic flexure and resection of the rectosigmoid junction . The colorectal anastomosis was stapled or manual without proximal stoma. In 53 females and 47 males (mean age 60.4 years), indications for surgery w ere: one or more attacks of acute diverticulitis (n = 70), abscess (n = 17) symptomatic stenosis (n = 8), colovesical fistula (n = 4) and diverticular bleeding (n = 1). Results - Mortality was nil. The conversion rate was 9%, never for anesthet ic reasons. The mean operating time was 226 +/- 68 min. There was no spleni c or ureteral injury. The morbidity at 30 days was 19% with fistulae rate a ccounting for 2%, 2 patients were reoperated on. The median time for passag e of flatus was 3 days and median length of hospital stay was 7 days. Late morbidity was 10%, one patient complained of retrograde ejaculation. Conclusion - This study demonstrates that laparoscopy is a safe alternative to laparotomy for elective one-stage colectomy For complicated diverticula r disease.