Increasing the number of attacks increases the conversion rate in laparoscopic diverticulitis surgery

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Outcomes

Background:

• Diverticulitis recurrence and complications can influence surgical management decisions.
• Elective laparoscopic sigmoid colectomy is a common procedure for recurrent diverticulitis.

Purpose of the Study:

• To investigate the impact of diverticulitis episode count on conversion and complication rates.
• To assess if a history of complicated diverticulitis, specifically abscess, affects laparoscopic sigmoid colectomy outcomes.

Main Methods:

• Retrospective review of 216 sigmoid colectomy cases.
• Statistical analysis using Student's t-test, chi-square, and Fisher's exact tests.
• Comparison of baseline characteristics, diverticulitis history, and intra/postoperative outcomes.

Main Results:

• Increased inpatient diverticulitis episodes (≥3) and abscess history were linked to higher laparoscopic conversion rates (25% vs 2.6% and 23% vs 8%, respectively).
• No significant differences in operative times or overall postoperative complication rates were observed.
• Converted procedures, while longer than open ones, resulted in shorter hospital stays and fewer postoperative ileus cases.

Conclusions:

• Multiple diverticulitis attacks and a history of abscess are predictors of laparoscopic conversion during sigmoid colectomy.
• Laparoscopic sigmoid colectomy is a safe option even for patients with multiple diverticulitis episodes or complicated histories.
• Conversion to open surgery, though requiring more time, is associated with improved patient recovery metrics.