[Laparoscopic resection-anastomosis in diverticular sigmoiditis and its complications apropos of 65 cases].

From 1992 to 1995, 77 cases of diverticular sigmoiditis were treated laparoscopically. Conversion to open surgery was required in only 6 cases. There were 27 cases with perforated sigmoid including 5 with peritonitis. Leakages from the anastomosis occurred intraoperatively in 3 cases and were repaired laparoscopically. Early complications were fistulae (n = 2.3%), occlusion by loop agglutination (n = 1) and Richter's hernia (n = 1). A cerebral vascular event lead to death in one patient over 80. Late complications were limited to extensible anastomotic diaphragms (27%) as no true stenoses were observed. There was 1 occlusion on bride and 1 eventration through the extraction orifice. Both were treated laparoscopically. Our overall results after laparoscopic treatment of diverticular sigmoiditis show a 3-fold increase in operative time over classical surgery without any modification in operative risks, a 2-fold reduction in intensive care after surgery and preserved parietal wall (10-fold reduction in the number of eventrations and to a lesser extent fewer occlusions). Laparoscopic surgery does however have its limitations in major peritoneo-occlusive syndromes and in patients with a high risk for anesthesia.