Abstract
Background
Guideline-concordant delay in elective laparoscopic colectomy for diverticulitis may
result in repeated bouts of inflammation. We aimed to determine whether conversion
rates from elective laparoscopic colectomy are higher after multiple episodes of diverticulitis.
Methods
Prospective cohort study evaluating laparoscopic colectomy conversion rates for diverticulitis
from 42 hospitals was conducted.
Results
Between 2010 and 2013, 1,790 laparoscopic colectomies for diverticulitis (mean age
57.8 ± 13; 47% male) resulted in 295 (16.5%) conversions. Conversion occurred more
frequently in nonelective operations (P < .001) and with fistula indications (P = .012). Conversion rates decreased with surgeon case volume (P = .028). Elective colectomy exclusively for episode-based indications (n = 784) had
a conversion rate of 12.9%. Increasing episodes of diverticulitis were not associated
with higher conversion rates, even among surgeons with similar experience levels.
Conclusions
Conversion from laparoscopic colectomy for diverticulitis did not increase after multiple
episodes of diverticulitis. Delaying elective resection appears to not prevent patients
from the benefits of laparoscopy.
Keywords
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Article Info
Publication History
Published online: February 24, 2015
Received in revised form:
December 23,
2014
Received:
October 16,
2014
Footnotes
Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number T32DK070555 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Surgical Care and Outcomes Assessment Program is a Coordinated Quality Improvement Program of the Foundation for Health Care Quality. The Comparative Effectiveness Research Translation Network is a program of the University of Washington, the academic research and development partner of Surgical Care and Outcomes Assessment Program.
Dr. Bastawrous reported Honoraria from Intuitive Surgical on his disclosure. The other authors declare no conflicts of interest.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
