Kolbe E W, Buciunas M, Krieg S, Loosen S H, Roderburg C, Krieg A, Kostev K
Department of General and Visceral Surgery, Thoracic Surgery and Proctology, Medical Campus OWL, University Hospital Herford, Ruhr University Bochum, Schwarzenmoorstr. 70, 32049, Herford, Germany.
Department of Inclusive Medicine, University Hospital Ostwestfalen-Lippe, Bielefeld University, 33617, Bielefeld, Germany.
Tech Coloproctol. 2025 Jan 16;29(1):46. doi: 10.1007/s10151-024-03092-1.
This study aims to evaluate the current rates and outcomes of minimally invasive versus open surgery for colonic diverticular disease in Germany, using a nationwide dataset.
We analyzed data from 36 hospitals, encompassing approximately 1.25 million hospitalizations from 1 January 2019 to 31 December 2023. Patients aged 18 years and older with colonic diverticular disease (International Classification of Diseases, Tenth Revision (ICD-10): K57.2 and K57.3) who underwent surgical treatment were included. Surgeries were classified as open or minimally invasive (laparoscopic or robotic). Outcomes such as in-hospital mortality, complications, and length of stay were assessed using multivariable logistic and linear regression models.
Out of 1670 patients who underwent surgery for colonic diverticular disease, 63.2% had perforation and abscess. The rate of minimally invasive surgery increased from 34.6% in 2019 to 52.9% in 2023 for complicated cases and from 67.8% to 86.2% for uncomplicated cases. Open surgery was associated with higher in-hospital mortality (odds ratio (OR): 7.41; 95% CI: 2.86-19.21) and complications compared with minimally invasive surgery. The length of hospital stay was significantly longer for open surgery patients, with an increase of 4.6 days for those with perforation and abscess and 5.0 days for those without.
Minimally invasive surgery for colonic diverticular disease is increasingly preferred in Germany, especially for uncomplicated cases. However, open surgery remains common for complicated cases, but is associated with higher mortality, more complications, and longer hospital stays.
本研究旨在利用全国性数据集评估德国结肠憩室病的微创手术与开放手术的当前发生率及治疗结果。
我们分析了36家医院的数据，涵盖2019年1月1日至2023年12月31日期间约125万例住院病例。纳入年龄在18岁及以上、患有结肠憩室病（国际疾病分类第十版（ICD - 10）：K57.2和K57.3）并接受手术治疗的患者。手术分为开放手术或微创手术（腹腔镜手术或机器人手术）。使用多变量逻辑回归和线性回归模型评估住院死亡率、并发症和住院时间等结果。
在1670例接受结肠憩室病手术的患者中，63.2%患有穿孔和脓肿。复杂病例的微创手术率从2019年的34.6%升至2023年的52.9%，非复杂病例从67.8%升至86.2%。与微创手术相比，开放手术的住院死亡率更高（比值比（OR）：7.41；95%置信区间：2.86 - 19.21）且并发症更多。开放手术患者的住院时间明显更长，穿孔和脓肿患者增加4.6天，无穿孔和脓肿患者增加5.0天。
在德国，结肠憩室病的微创手术越来越受到青睐，尤其是非复杂病例。然而，复杂病例中开放手术仍然常见，但与更高的死亡率、更多并发症和更长的住院时间相关。
