Anania G, Vedana L, Santini M, Scagliarini L, Giaccari S, Resta G, Cavallesco G
G Chir. 2014 May-Jun;35(5-6):126-8.
Surgical treatment of complicated colonic diverticular disease is still debatable. The aim of our study was to evaluate the outcome of laparoscopic colon resection in patients with diverticulitis and with complications like colon-vescical fistula, peridiverticular abscess, perforation or stricture. All patients underwent laparoscopic colectomy within 8 years period. Main data recorded were age, sex, return of bowel function, operation time, duration of hospital stay, ASA score, body mass index (BMI), early and late complications. During the study period, 33 colon resections were performed for diverticulitis and complications of diverticulitis. We performed 5 associated procedures. We had 2 postoperative complications; 1 of these required a redo operation with laparotomy for anastomotic leak and 3 patients required conversion from laparoscopic to open colectomy. The most common reasons for conversion were related to the inflammatory process with a severe adhesion syndrome. Mean operative time was 229 minutes, and average postoperative hospital stay was 9,8 days. Laparoscopic surgery for complications of diverticular disease is safe, effective and feasible. Laparoscopic colectomy has replaced open resection as standard surgery for recurrent and complicated diverticulitis in our institution.
复杂结肠憩室病的外科治疗仍存在争议。我们研究的目的是评估腹腔镜结肠切除术治疗憩室炎及伴有结肠膀胱瘘、憩室周围脓肿、穿孔或狭窄等并发症患者的疗效。所有患者均在8年期间内接受了腹腔镜结肠切除术。记录的主要数据包括年龄、性别、肠功能恢复情况、手术时间、住院时间、美国麻醉医师协会（ASA）评分、体重指数（BMI）、早期和晚期并发症。在研究期间，因憩室炎及其并发症进行了33例结肠切除术。我们还进行了5例相关手术。术后出现2例并发症；其中1例因吻合口漏需开腹再次手术，3例患者需由腹腔镜手术转为开腹结肠切除术。转为开腹手术最常见的原因与炎症过程导致的严重粘连综合征有关。平均手术时间为229分钟，术后平均住院时间为9.8天。腹腔镜手术治疗憩室病并发症是安全、有效且可行的。在我们机构，腹腔镜结肠切除术已取代开腹切除术，成为复发性和复杂性憩室炎的标准手术方式。
