Use and outcomes of emergent laparoscopic resection for acute diverticulitis

作者：Rea Jennifer D; Herzig Daniel O; Diggs Brian S; Cone Molly M; Lu Kim C^*

来源：American Journal of Surgery, 2012, 203(5): 639-643.

DOI：10.1016/j.amjsurg.2012.01.004

• Laparoscopy
• Colectomy
• Acute
• Diverticulitis
• Colon resection
• Sigmoidectomy

BACKGROUND: The use and outcomes of laparoscopic sigmoid resection during emergency admissions for diverticulitis are unknown. %26lt;br%26gt;METHODS: The Nationwide Inpatient Sample was queried for colorectal resections performed for diverticulitis during emergent hospital admissions (2003-2007). Univariate and multivariate analyses including patient, hospital, and outcome variables were performed. %26lt;br%26gt;RESULTS: A national estimate of 67,645 resections (4% laparoscopic) was evaluated. The rate of conversion to open operation was 55%. Ostomies were created in 66% of patients, 67% open and 41% laparoscopic. Laparoscopy was not a predictor of mortality (odds ratio [OR] =.70; confidence interval [CI], .32-1.53). Laparoscopy predicted routine discharge (OR = 1.31; CI, 1.06-1.63) and a decreased length of stay (absolute days = -.78; CI, -1.19 to -.37). There was no difference in the cost of hospitalization between the 2 groups (P = .45). %26lt;br%26gt;CONCLUSIONS: In acute diverticulitis, urgent laparoscopic resection decreases the length of stay. However, it is associated with a high conversion rate, no cost savings, and no difference in mortality.

• 出版日期2012-5