Laparoscopic Resection of Chronic Sigmoid Diverticulitis

Background and Objectives: A growing number of op-erations for sigmoid diverticulitis are being done laparo-scopically. There is a paucity of data on the outcome of laparoscopy for sigmoid diverticulitis complicated by co-lonic fistula. The aim of this study was to compare the results of laparoscopic resection of sigmoid diverticulitis with and without colonic fistula. Methods: A retrospective review was conducted of all patients who underwent laparoscopic resection of sig-moid diverticulitis complicated by fistula at a single ter-tiary care institution over a 7-year period. Comparison was made with a group of patients who underwent resection for diverticulitis without fistula during the same study period. Results: Forty-two patients were analyzed (group 1: di-verticular fistula, group 2: no fistula). The median age was similar (49 vs. 50 years, P .68). A chronic abscess was present in 24 % of patients in group 1 and 10 % in group 2 (P .40). Fistula types were colovesical (71%), colovagi-nal (19%), and colocutaneous (10%). Operation types were sigmoidectomy (57 % vs. 81%) and anterior resection (43 % vs. 19%) in groups 1 and 2, respectively (P .18). Ureteral catheters were used more frequently in group 1 (67 % vs. 33 % [P .06]). No difference was noted in operative time, blood loss, conversion rate, length of stay, overall complications, wound infection rate, readmission rate, reoperation rate, and mortality. All patients healed without fistula recurrence. Conclusions: Patients with sigmoid diverticulitis with fis-tula can be successfully treated with laparoscopic exci-sion, with similar outcomes for patients without fistula