SHORT-TERM OUTCOMES OF LAPAROSCOPIC ELECTIVE COLONIC RESECTIONS FOR DIVERTICULAR DISEASE

Abstract

AIM: to assess the feasibility and safety of laparoscopic elective colon resections for diverticular DISEASE. PATIENTS AND METHODS: a retrospective non-randomized study included 38 patients with elective colon resection about diverticular disease. Twenty-six underwent laparoscopic resections (main group), 12 – open resections (controls). The indications for surgery were: chronic diverticulitis, pericolic abdominal mass, external and internal colon fistulas and strictures of colon. RESULTS: operation time was the same in both groups (167.1±73.3 vs 129.9±43.7 min, p=0.06). Thirty-three (86.8%) resections were performed with a colorectal anastomosis and 5 (13.2%) obstructive resections of the sigmoid colon. In the main group, the inferior mesenteric artery (IMA) was ligated at the ramification point in 4 (15.4%) cases, in the control group – in 6 (50%) (p=0.045). The anastomotic leakage in the main group was in 3 (11.5%) patients, in the control group – in 1 (8.3%) (p=1.0). The postoperative period was significantly shorter in the main group compared with the controls (9.3±2.8 vs 13.4±5.1 days, p=0.003). After laparoscopic procedures, narcotic analgesics were used in 3 (11.5%) cases, after conventional – in 8 (66.7%) (p=0.001). CONCLUSION: laparoscopic approach is comparable to the conventional one in operative time and postoperative morbidity. Laparoscopic approach is associated with a significantly less postoperative pain syndrome and a shorter postoperative period, more often allows to preserve the IMA as well.