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Am J Surg. 2015 May;209(5):913-8; discussion 918-9. doi: 10.1016/j.amjsurg.2014.12.027. Epub 2015 Feb 25.

The impact of delaying elective resection of diverticulitis on laparoscopic conversion rate.

Author information

1
Department of Surgery, University of Washington, Seattle, WA, USA. Electronic address: vsimianu@uw.edu.
2
Department of Surgery, University of Washington, Seattle, WA, USA.
3
Department of Surgery, Swedish Medical Center, Seattle, WA, USA.
4
Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
5
Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA.
6
Department of Surgery, Virginia Mason Medical Center, Seattle, WA, USA.

Abstract

BACKGROUND:

Guideline-concordant delay in elective laparoscopic colectomy for diverticulitis may result in repeated bouts of inflammation. We aimed to determine whether conversion rates from elective laparoscopic colectomy are higher after multiple episodes of diverticulitis.

METHODS:

Prospective cohort study evaluating laparoscopic colectomy conversion rates for diverticulitis from 42 hospitals was conducted.

RESULTS:

Between 2010 and 2013, 1,790 laparoscopic colectomies for diverticulitis (mean age 57.8 ± 13; 47% male) resulted in 295 (16.5%) conversions. Conversion occurred more frequently in nonelective operations (P < .001) and with fistula indications (P = .012). Conversion rates decreased with surgeon case volume (P = .028). Elective colectomy exclusively for episode-based indications (n = 784) had a conversion rate of 12.9%. Increasing episodes of diverticulitis were not associated with higher conversion rates, even among surgeons with similar experience levels.

CONCLUSIONS:

Conversion from laparoscopic colectomy for diverticulitis did not increase after multiple episodes of diverticulitis. Delaying elective resection appears to not prevent patients from the benefits of laparoscopy.

KEYWORDS:

Colectomy; Complication; Conversion; Diverticulitis; Elective; Laparoscopy

PMID:
25773308
PMCID:
PMC4426006
DOI:
10.1016/j.amjsurg.2014.12.027
[Indexed for MEDLINE]
Free PMC Article

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