Document Detail


Laparoscopy improves short-term outcomes after surgery for diverticular disease.
MedLine Citation:
PMID:  20193685     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Observational studies and small randomized controlled trials have shown that the use of laparoscopy in colon resection for diverticular disease is feasible and results in fewer complications. We analyzed data from a large, prospectively maintained, multicenter database (National Surgical Quality Initiative Program) to determine whether the use of laparoscopy in the elective treatment of diverticular disease decreases rates of complications compared with open surgery, independent of preoperative comorbid factors.
METHODS: The analysis included data from 6970 patients who underwent elective surgeries for diverticular disease from 2005 to 2008. Patients with diverticular disease were identified by International Classification of Diseases, 9th revision codes and then categorized into open or laparoscopic groups based on Current Procedural Terminology codes. Preoperative, intraoperative, and postoperative data were analyzed to determine factors associated with increased risk for postoperative complications.
RESULTS: Data were analyzed from 3468 patients who underwent open surgery and 3502 patients who underwent laparoscopic procedures. After correcting for probability of morbidity, American Society of Anesthesiology class, and ostomy creation, overall complications (including superficial surgical site infections, deep incisional surgical site infections, sepsis, and septic shock) occurred with significantly lower incidence among patients who underwent laparoscopic procedures compared with those who received open operations.
CONCLUSIONS: The use of laparoscopy for treating diverticular disease, in the absence of absolute contraindications, results in fewer postoperative complications compared with open surgery.
Authors:
Andrew J Russ; Kari L Obma; Victoria Rajamanickam; Yin Wan; Charles P Heise; Eugene F Foley; Bruce Harms; Gregory D Kennedy
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Publication Detail:
Type:  Journal Article     Date:  2010-02-26
Journal Detail:
Title:  Gastroenterology     Volume:  138     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2010-07-01     Revised Date:  2012-01-13    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2267-74, 2274.e1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery, Section of Colon and Rectal Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53972, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Colectomy / methods*
Diverticulitis / surgery*
Female
Humans
Laparoscopy / methods*
Male
Middle Aged
Multivariate Analysis
Postoperative Complications / etiology,  prevention & control
Grant Support
ID/Acronym/Agency:
T32 CA090217-09/CA/NCI NIH HHS
Comments/Corrections
Comment In:
Gastroenterology. 2010 Jun;138(7):2213-6   [PMID:  20435008 ]

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