Use and outcomes of emergent laparoscopic resection for acute diverticulitis

Department of Surgery, Oregon Health & Science University, Mail Code L223, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
American journal of surgery (Impact Factor: 2.36). 03/2012; 203(5):639-43. DOI: 10.1016/j.amjsurg.2012.01.004
Source: PubMed

ABSTRACT The use and outcomes of laparoscopic sigmoid resection during emergency admissions for diverticulitis are unknown.
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.
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).
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.