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EMERGENCY LAPAROSCOPIC‐ASSISTED VERSUS OPEN RIGHT HEMICOLECTOMY FOR COMPLICATED CAECAL DIVERTICULITIS: A COMPARATIVE STUDY OF SHORT‐TERM OUTCOMES
Author(s) -
Li J.C.M.,
Ng S.S.M.,
Lee J.F.Y.,
Yiu R.Y.C.,
Leung K.L.
Publication year - 2007
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2007.00349_4.x
Subject(s) - medicine , diverticulitis , blood loss , surgery , right hemicolectomy , laparoscopy , complication , general surgery , colorectal cancer , cancer
Aim: The aim of this study was to compare the operative and short‐term clinical outcomes of emergency laparoscopic‐assisted versus open right hemicolectomy for complicated caecal diverticulitis. Methods: Between September 2001 and June 2006, 18 consecutive patients with complicated caecal diverticulitis underwent emergency right hemicolectomy at out institution, six with the laparoscopic‐assisted approach and 12 with the open approach. Clinical data were prospectively recorded and compared between the two groups. Results: There were no significant differences between the two groups with respect to age, gender, comorbidities, duration of symptoms, and Hinchey staging. There was no conversion in the laparoscopic‐assisted group. Compared to the open group, the laparoscopic‐assisted group had a slightly longer operative time (167.5 vs 150 min, P = 0.083) but significantly less blood loss (35 vs 100 mL, P = 0.041). Although the median time to first bowel motion was significantly shorter in the laparoscopic‐assisted group (3 vs 5 days, P = 0.041), the time to full ambulation and the duration of hospital stay were similar between the two groups. The postoperative complication rates (50% vs 33.3%), as well as the hospital readmission rates for complications (33% vs 0%), were higher in the open group than the laparoscopic‐assisted group, but the differences did not reach statistical significance. Conclusion: Emergency laparoscopic‐assisted right hemicolectomy for complicated caecal diverticulitis is feasible and safe in the hands of experienced surgeons. Compared with the open approach, the laparoscopic‐assisted approach is associated with less blood loss and earlier return of gastrointestinal function.