Laparoscopic treatment of sigmoid diverticulitis: a retrospective review of 103 cases

Pugliese, Raffaele; Lernia, Stefano Di; Sansonna, Fabio; Scandroglio, Ildo; Maggioni, Dario; Ferrari, C; Costanzi, Andrea; Chiara, Osvaldo

doi:10.1007/s00464-003-9178-6

Cited by 77 publications

(88 citation statements)

References 24 publications

(19 reference statements)

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“…Our complication rate is consistent with other published series 4,12,16 . The majority of intraoperative injuries were vascular and bowel perforations and were managed laparoscopically in 70% of cases.…”

Section: Discussionsupporting

confidence: 93%

Colectomia eletiva laparoscópica esquerda para a doença diverticular: estudo monocêntrico sobre 205 pacientes consecutivos

Pinto

Fallatah

Espalieu

et al. 2010

ABCD, arq. bras. cir. dig.

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-Background -The increased prevalence of diverticular disease has made its most appropriate management a matter of constant debate. Especially for the cases of diverticulitis, considerable progress has been made in terms of diagnosis and management.The surgical resection of the involved colon is the only means of definitely eradicate this condition and so, the elective laparoscopic colectomy has emerged as a safe and interesting choice among the options of treatment. Aim -To analyze the outcomes of the laparoscopic left colectomy for diverticular disease performed over a 17-year period at a single institution. Methods -Between April 1990 and May 2007, a total of 205 consecutive left laparoscopic colectomies were retrospectively reviewed. Data obtained included the pre-operative workup, indications for surgery, operative results, complications and follow-up. Univariate and multivariate statistical analyzes were performed in an effort to identity risk factors for adverse outcomes in the series. Results -Indications were for non-complicated acute diverticulitis (80%), acute or chronic complicated diverticulitis (18.05%) and bleeding diverticular disease (1.95%). The conversion rate was 5.85% (12 cases). The median operative time was 180 (100-420) min with a hospital stay of 7 (5-44) days. The mean length of the resected specimen was 29.12 (+8.2) cm. Most cases (88.3%) had an unremarkable postoperative course but complications occurred in 24 (11.7%) patients. In order of frequency, these were: paralytic ileus (n=6), pelvic collections (n=4), bowel obstructions (n=4) and fistulas (n=2), among others. A re-operation was necessary in eight cases and there was one death (0.48%). Median follow-up was 26.5 (1-156) months with a satisfying result seen in 179 (87.32%) of the patients. In 18 (8.78%) cases, persistent symptoms of functional colonic disorders were noted. There were 7 (3.41%) anastomotic stenosis in witch two needed a re-operation. The recurrence rate was 1.95% (4 cases). Age and intraoperative complications were identified as risk factors for conversion. The presence of associated lesions was significantly correlated with the persistence of functional colonic symptoms during the follow-up. ConclusionsThe laparoscopic left colectomy is safe and effective in comparison to all other modalities of management for diverticular disease. Precise diagnosis and respect of the current indications are essential to achieve such results.RESUMO -Racional -O aumento da prevalência de doença diverticular tornou o seu manuseio mais adequado uma questão de debate constante. Especialmente para os casos de diverticulite, progresso considerável tem sido feito em termos de diagnóstico e tratamento. A ressecção cirúrgica do cólon envolvido é a única maneira de erradicar definitivamente essa condição e, portanto, a colectomia laparoscópica eletiva surgiu como uma opção segura e interessante entre as várias formas de tratamento. Objetivo -Analisar os resultados das colectomias laparoscópicas esquerdas para a doença diverticula...

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Section: Discussionsupporting

confidence: 93%

Colectomia eletiva laparoscópica esquerda para a doença diverticular: estudo monocêntrico sobre 205 pacientes consecutivos

Pinto

Fallatah

Espalieu

et al. 2010

ABCD, arq. bras. cir. dig.

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“…There have been limited case reports on laparoscopic pancreatoduodenectomy (Table 3) (Gagner & Pomp, 1997;Staudacher et al, 2005;Dulucq et al, 2006;Palanivelu et al, 2007;Pugliese et al, 2008;Cho et al, 2009;Kendrick & Cusati, 2010), and some surgeons advocate its safety and feasibility. However, lack of tactile sensation, difficulties in localizing lesions, and the anatomic complexity of peripancreatic organs to make laparoscopic pancreatoduodenectomy difficult (Cuschieri, 1996).…”

Section: Pancreatoduodenectomymentioning

confidence: 99%

“…Nevertheless, laparoscopic experience has allowed some surgeons to claim promising results for laparoscopic pancreatoduodenectomy (Gagner & Pomp, 1997;Staudacher et al, 2005;Dulucq et al, 2006;Palanivelu et al, 2007;Pugliese et al, 2008;Cho et al, 2009;Kendrick & Cusati, 2010;Cuschieri, 1996).…”

Section: Pancreatoduodenectomymentioning

confidence: 99%

Laparoscopic Pancreatic Surgery

Jang¹

2012

Advances in Laparoscopic Surgery

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“…To date, only a handful of laparoscopic pancreatic resection series have been published and very few of them report more than 50 cases [1][2][3][4][5][6][7][8][9][10]. Gagner et al [11] previously presented work on laparoscopic pancreatic head resections, but such small series have remained substantially experimental.…”

Section: Introductionmentioning

confidence: 99%

Robotic‐assisted pancreatic surgery

Fernandes

Giulianotti

2013

J Hepato Biliary Pancreat

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Background Pancreatic surgery is a challenging application of minimally invasive surgery. Due to the complexity of the surgical technique, requiring dissection along major abdominal vessels as well as delicate reconstruction involving biliary, pancreatic and enteric anastomoses, reports on laparoscopic pancreatic surgery have been scanty. With the advent of robotic-assisted surgery, however, the increased dexterity granted by endo-wristed instruments, the improved three-dimensional vision and the computer filtration of the surgeon's movements have brought minimally invasive pancreatic surgery into a new era. Methods As the surgical group which has performed the highest number of robotic-assisted pancreatic procedures worldwide, we review the state of the art of minimally invasive robotic-assisted pancreatic surgery. Clinical results from all major robotic-assisted pancreatic surgery series are considered. Results Preliminary reports from the published major pancreatic surgery series show encouraging results, with morbidity and mortality comparable to open surgery. Preliminary data on cancer survival rates also appear to be similar to open series. Conclusion Robotic-assisted pancreatic surgery is safe and feasible for all pancreatic diseases. The complexity of pancreatic procedures warrant them to be carried out in specialised centres, where short-and long-term outcomes seem to be similar to the ones achieved in open surgery.

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Laparoscopic treatment of sigmoid diverticulitis: a retrospective review of 103 cases

Abstract: Laparoscopic surgery for sigmoid diverticulitis in experienced hands can be a safe and effective gold standard procedure also for patients with fistula or purulent peritonitis.

Cited by 77 publications

References 24 publications

Colectomia eletiva laparoscópica esquerda para a doença diverticular: estudo monocêntrico sobre 205 pacientes consecutivos

Colectomia eletiva laparoscópica esquerda para a doença diverticular: estudo monocêntrico sobre 205 pacientes consecutivos

Laparoscopic Pancreatic Surgery

Robotic‐assisted pancreatic surgery

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