The Evolving Role of Laparoscopy in Colonic Diverticular Disease: A Systematic Review
Corresponding Author
Wolfgang B. Gaertner
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
[email protected]Search for more papers by this authorMary R. Kwaan
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorRobert D. Madoff
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorDavid Willis
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorGeorge E. Belzer
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorDavid A. Rothenberger
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorGenevieve B. Melton
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorCorresponding Author
Wolfgang B. Gaertner
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
[email protected]Search for more papers by this authorMary R. Kwaan
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorRobert D. Madoff
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorDavid Willis
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorGeorge E. Belzer
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorDavid A. Rothenberger
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorGenevieve B. Melton
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, 55455 Minneapolis, MN, USA
Search for more papers by this authorAbstract
Background
A PubMed search of the biomedical literature was carried out to systematically review the role of laparoscopy in colonic diverticular disease. All original reports comparing elective laparoscopic, hand-assisted, and open colon resection for diverticular disease of the colon, as well as original reports evaluating outcomes after laparoscopic lavage for acute diverticulitis, were considered. Of the 21 articles chosen for final review, nine evaluated laparoscopic versus open elective resection, six compared hand-assisted colon resection versus conventional laparoscopic resection, and six considered laparoscopic lavage. Five were randomized controlled trials.
Results
Elective laparoscopic colon resection for diverticular disease is associated with increased operative time, decreased postoperative pain, fewer postoperative complications, less paralytic ileus, and shorter hospital stay compared to open colectomy. Laparoscopic lavage and drainage appears to be a safe and effective therapy for selected patients with complicated diverticulitis.
Conclusions
Elective laparoscopic colectomy for diverticular disease is associated with decreased postoperative morbidity compared to open colectomy, leading to shorter hospital stay and fewer costs. Laparoscopic lavage has an increasing but poorly defined role in complicated diverticulitis.
References
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