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A Comprehensive Review of Laparoscopic Left Colectomy for Acute Diverticulitis: Techniques, Outcomes and
Danilo Coco1, Silvana Leanza1, Massimo Giuseppe Viola2
1Department of General, Robotic and Oncologic Surgery, Giglio Foundation Hospital Cefalu', Palermo, Italy.
Background:
Laparoscopic left colectomy has emerged as a potential alternative to open surgery for the treatment of acute diverticulitis. However, the evidence on the safety and efficacy of this approach is still subject to debate.
Aim:
This review aims to provide a comprehensive overview of the techniques, outcomes and complications associated with laparoscopic left colectomy for acute diverticulitis.
Methods:
A systematic review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that met the inclusion criteria were analyzed for patient demographics, surgical techniques, outcomes and complications.
Results:
A total of 23 studies involving a total of 3,214 patients who underwent laparoscopic left colectomy for acute diverticulitis was conducted. The majority of studies reported favorable outcomes for laparoscopic left colectomy, with patients experiencing shorter hospital stays, less postoperative pain and a faster return to normal activities. Specifically, the studies reported an average hospital stay of 5-7 days for laparoscopic left colectomy patients compared to 7-10 days for open colectomy patients. Additionally, laparoscopic patients reported lower pain scores and required fewer pain medications, with a reduced need for opioid analgesics. However, there were also some complications reported in these studies, including anastomotic leakage, wound infections and intra-abdominal abscesses. The overall incidence of complications was relatively low, ranging from 4-18% depending on the study. The risk of complications was generally higher in patients with severe acute diverticulitis or those undergoing emergency surgery.
Conclusion:
Laparoscopic left colectomy is a safe and effective approach for the treatment of acute diverticulitis, offering several potential benefits compared to open surgery. However, there is a need for further research to clarify the optimal patient selection criteria, surgical techniques and management of complications.
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