Original Articles
Evaluation of Laparoscopic Management of Colonic Diverticular Disease and Its Complications: An Institutional Based Study | |
T Narayana Raju, Srinivasulu Bandam | |
Introduction: Colonic diverticular disease refers to an entity where a small expelled out pouching of the large intestinal wall takes place. Colon diverticular disease is very common in some parts of western world with a prevalence ranging 33 % in patients over 60 years of age. The prevalence of colonic diverticulosis is gradually increasing day by day in western and Asian countries. Diverticular disease can also be referred as clinically significant and symptomatic diverticulosis mostly complicated by diverticulitis, diverticular bleeding, segmental colitis associated with diverticula or symptomatic uncomplicated diverticular disease; these are the well documented complications of colonic diverticulosis. Materials and Methodology: The present study was conducted for evaluating the laparoscopic management of colonic diverticular disease and its complications.During the elapsed study period, there were about 431 patients who had undergone laparoscopic surgery for the colorectal diseases. Of which, there were 42 (9.7 %) patients who had undergone laparoscopic treatment for diverticulitis.For diverticular disease, none of the patients required open surgery. An analysis was conducted on the disease's demographic characteristics, clinical manifestation, modified Hinchey stage, and therapeutic approach. In cases with diverticular illness, a pericolic abscess, two or more bouts of confirmed diverticulitis, perforation characteristics, and/or peritonitis were indications for surgery. If the preoperative CT scan showed that the ureter was near the inflammatory mass, preventive ureteric stenting was performed before surgery. Results: There were about 431 patients who had undergone laparoscopic surgery for the colorectal diseases. Of which, there were 42 (9.7 %) patients who had undergone laparoscopic treatment for diverticulitis. Comorbidities were seen in 30.95 percent of the patients. Sigmoid was the most common site of involvement found to be present in 80.95 percent of the patients.Primary resection anastomosis was done in 4.76 percent of the patients. Mean operative time was 269.3 minutes. Morbidity was 9.52 percent. Mean hospital stay was 10.23 days.Conclusion: Diverticulosis is complicated by diverticulitis, diverticular bleeding and segmental colitis associated with diverticula all of which report frequently. |
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