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Mori H, Tsushimi T, Kobara H, Nishiyama N, Fujihara S, Matsunaga T, Ayagi M, Yachida T, Masaki T. Endoscopic management of a rare granulation polyp in a colonic diverticulum. World J Gastroenterol 2013; 19:9481-9484. [PMID: 24409079 PMCID: PMC3882425 DOI: 10.3748/wjg.v19.i48.9481] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 10/01/2013] [Accepted: 10/14/2013] [Indexed: 02/06/2023] Open
Abstract
There are many case reports on colon diverticula that cause irritable bowel syndrome, constipation, bleeding, diverticulitis, stricture due to multiple recurrences of diverticulitis, and perforation. However, few articles have examined neoplasms that arise from a diverticulum, such as adenoma and adenocarcinoma, and there have been no reports of granulation polyps that arise from a colon diverticulum after recurrent diverticulitis. We observed a rare granulation polyp that arose from a diverticulum as a result of repeated episodes of local diverticulitis. Narrow band imaging magnified colonoscopy was very useful to diagnose the polyp as a granulation polyp because of the absence of a pit pattern on the surface of the polyp. We successfully resected the polyp using endoscopic mucosal resection. We inverted the diverticulum, and the resected stalk of the polyp was used to close the diverticulum with an over-the-scope clip. If a granulomatous polyp could arise from a diverticulum, differential diagnosis between a colon neoplasm and a granulomatous polyp would not only be difficult but also necessary for suitable endoscopic treatment.
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52
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Stavitskiĭ VV. [Results of surgical rehabilitation of patients in the presence of external colonic fistula in conditions of district hospital]. KLINICHNA KHIRURHIIA 2013:20-23. [PMID: 24171283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Results of treatment of 102 patients for a variety of injuries and surgical diseases of the colon, who performed the intervention, culminating in the formation of the external colonic fistula (ECF) were analyzed. After reconstructive and restorative surgery for ECF, all patients were alive. Postoperative complications occurred in 15 (20.8%) patients, including intraabdominale--in 2 (2.8%). The optimal timing of surgical rehabilitation and volume reduction or reconstructive surgery in patients over the ECF should be determined strictly individual basis, taking into account the severity and nature of the illness or injury, which required imposition of an stoma, the severity of postoperative scar and local inflammatory processes in the abdominal cavity, in laparotomic wound and fistula. Performing simultaneous operations in the surgical rehabilitation of patients with ECF practically does not increase the risk of postoperative complications.
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53
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Tutchenko MI, Andriiets' VS, Kliuzko IV, Marchuk SF, Iakovenko AA, Kravtsov DI. [Manual-assisted laparoscopic interventions in coloproctologic diseases]. KLINICHNA KHIRURHIIA 2013:17-19. [PMID: 24171282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Feasibility of manual-assisted laparoscopic surgery in the treatment of coloproctologic diseases was designated. The investigation included 25 patients operated on for diseases of the colon. In 11 of them made manual-assisted laparoscopic surgery. Length of cut with manual-assisted laparoscopic interventions in 3.8 times less conventional laparotomy section, the total blood loss was 2.3 times less than in open surgery. Duration of patients rehabilitation after such surgery is 1.8 times less than after laparotomy. Laparoscopic surgery of the hand asystens in coloproctology mini-invasive is, however, retain the advantages of open surgery. At the present stage of coloproctology are, on the one hand, is the first step to classic laparoscopic surgery on the other--an alternative to conversion.
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54
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Vrbenský L, Simša J. [Laparoscopic resection of the sigmoid colon for the diverticular disease]. ROZHLEDY V CHIRURGII : MESICNIK CESKOSLOVENSKE CHIRURGICKE SPOLECNOSTI 2013; 92:414-419. [PMID: 24003883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Laparoscopic resection of the sigmoid colon for diverticular disease is nowadays a fully accepted alternative to traditional open procedures. AIM The aim of this work is to summarize the indications, advantages and risks of laparoscopic sigmoid resection for diverticular disease. METHODS Review of the literature and recent findings concerning the significance of laparoscopic resection for diverticulosis of the sigmoid colon. CONCLUSION The article presents the indications, risks, techniques and perioperative care in patients after laparoscopic resection of the sigmoid colon for diverticular disease.
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Levý M, Herdegen P, Sutoris K, Simša J. [Diverticular disease of the large bowel - surgical treatment]. ROZHLEDY V CHIRURGII : MESICNIK CESKOSLOVENSKE CHIRURGICKE SPOLECNOSTI 2013; 92:408-413. [PMID: 24003882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Surgical treatment, despite the rapid development of the numerous modern miniinvasive intervention techniques, remains essential in the treatment of complicated diverticular disease. AIM The aim of this work is to summarize indications for surgical treatment in both acute and elective patients suffering from diverticular disease of the large bowel. METHODS Review of the literature and recent findings concerning indications for surgical intervention in patients with diverticulosis of the colon. CONCLUSION The article describes indications, types of procedures, techniques and postoperative care in patients undergoing surgical intervention for diverticular disease.
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56
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[Court decision of LG Fulda of 28 May 2009, AZ: 2 O 460/07 / court decision OLG Kassel of 27 November 2012, AZ: 14 U 134/09 - diagnostic assessment error by omission of relaparotomy]. Zentralbl Chir 2013; 138:137-139. [PMID: 23682363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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57
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Timofeev ME, Krechetova AP, Fedorov ED, Shapoval'iants SG. [The clinical presentation, diagnostics and treatment of pathological changes of the epiploic appendices]. Khirurgiia (Mosk) 2013:77-83. [PMID: 24579106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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58
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Shelygin IA, Achkasov SI, Moskalev AI, Likhter MS, Zarodniuk IV, Skridlevskiĭ SN, Trubacheva IL. [Colovesical fistula as a complication of diverticular disease]. UROLOGIIA (MOSCOW, RUSSIA : 1999) 2013:17-23. [PMID: 23662489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The results of research on the clinical picture, features of manifestation, diagnosis, and treatment of patients with diverticular disease complicated by sigmovesical fistula are presented. The study included 31 patients (19 [61.3%] men, 12 [38.7%] women), aged 32-83 (55.6 +/- 7.1) years. Diagnostic program included physical examination, laboratory blood and urine tests, endoscopic, radiological, ultrasound examinations. All patients underwent different interventions according to the severity and extent of the inflammatory process, the involvement of other organs of the abdominal cavity and the extent of diverticular lesions of the colon. Long-term results were assessed in all patients in a period of 5 months to 12 years, with a median follow-up 4.7 years. It is shown that the clinical manifestations of intestinovesical fistula did not match the severity of complications, and were subclinical. Timing for referral the patient to coloproctologist was 5 months after the occurrence of first clinical signs. In any case, conservative treatment has not led to spontaneous colovesical fistula closure. Average size of parafistulous infiltration on the wall of the bladder and perivesical tissue was 6.5 +/- 2.4 cm. All the patients underwent different types of colon resection. Postoperative complications did not requiring recurrent surgery were detected in 5 (16.1%) patients. None of these has experienced recurrence complications of diverticular disease. For the optimization the treatment strategy, physicians should follow multidisciplinary approach immediately after revealing the patient with persistent bacteriuria, pneumaturia and fecaluria. The surgery is the method of choice in the treatment of colovesical fistula as a complication of diverticular disease.
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59
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Zícari M, Ale P, Odone H, Odone J, Figueroa M. A rare cause of abdominal tumor. ACTA GASTROENTEROLOGICA LATINOAMERICANA 2012; 42:269-353. [PMID: 23383517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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60
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Filippucci E, Pugliese L, Pagliuca V, Crusco F, Pugliese F. Giant sigmoid diverticulum: a rare cause of common gastrointestinal symptoms. Intern Emerg Med 2012; 7 Suppl 2:S149-51. [PMID: 22411617 DOI: 10.1007/s11739-012-0769-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 03/01/2012] [Indexed: 12/11/2022]
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61
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Mahamid A, Ashkenazi I, Sakran N, Zeina AR. Giant colon diverticulum: rare manifestation of a common disease. THE ISRAEL MEDICAL ASSOCIATION JOURNAL : IMAJ 2012; 14:331-332. [PMID: 22799070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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62
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Bi JT, Guo YT, Zhao JM, Zhang ZT. Stercoral colonic diverticulum perforation with jejunal diverticulitis mimicking upper gastrointestinal perforation. Chin Med J (Engl) 2012; 125:536-538. [PMID: 22490417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Stercoral perforation of the colon is an unusual pathological condition with fewer than 150 cases reported in the literature to date. We present a case of stercoral colonic perforation mimicking upper gastrointestinal perforation, which was diagnosed by computed tomography preoperatively. However, at laparotomy, stercoral colonic diverticulum perforation with jejunal diverticulitis became the most appropriate diagnosis.
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63
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Fleshman JW. Learning to recycle. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 2011; 146:1156. [PMID: 22121532 DOI: 10.1001/archsurg.2011.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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64
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Soga K, Takenaka S, Ishida E, Kobayashi Y, Kanemitsu D, Nakase Y, Takagi T, Fukumoto K, Sakamoto K, Kassai K, Miyagaki T, Yanagida K, Itani K, Naito Y, Yanagisawa A, Yoshikawa T. Advanced adenocarcinoma in a laterally spreading adenoma within a colonic diverticulum, followed-up for 4 years. Acta Gastroenterol Belg 2011; 74:477-478. [PMID: 22103059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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65
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Cavaliere F, Biasucci D, Costa R, Soave M, Addabbo G, Proietti R. Chest ultrasounds to guide manual reexpansion of a postoperative pulmonary atelectasis: a case report. Minerva Anestesiol 2011; 77:750-753. [PMID: 21709662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Reexpansion of a pulmonary atelectasis is often difficult, even after removing possible causes of bronchial obstruction. Chest ultrasounds, inexpensive and readily available at the patient bedside, may offer valuable support to guide recruitment maneuvers. We report the case of a 57-year-old woman that developed a complete collapse of the left lung seven days after undergoing an intestinal resection for perforation. A mucous plug occluding the main bronchus was removed with bronchoscopy, but persistent hypoxemia required mechanical ventilation; 24 hours later, an attempt to wean the patient from the ventilator failed. Chest X-rays revealed the persistence of a partial collapse of the left inferior lobe associated with a pleural effusion. A chest ultrasound confirmed the presence of a lung consolidation and of a modest pleural effusion. Manual reexpansion was then attempted, and ventilatory pressures as well as the duration of forced inspirations were based on real-time ultrasound images. Complete reexpansion was achieved within a few minutes and confirmed by chest X-ray. The patient was weaned from mechanical ventilation on the same day and discharged from ICU three days later.
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66
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Martens T, Fierens K. Giant cecal diverticulum in a child. J Pediatr Surg 2011; 46:e23-5. [PMID: 21683187 DOI: 10.1016/j.jpedsurg.2011.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Revised: 02/06/2011] [Accepted: 03/08/2011] [Indexed: 11/18/2022]
Abstract
A 12-year-old girl with abdominal pain and fever underwent urgent surgery. As was suspected on computed tomographic scan, a large diverticular mass adherent to the cecum was identified. A diverticulectomy was performed. We report this rare case of a giant cecal diverticulum and provide an overview of known literature.
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67
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de Campos-Lobato LF, Alves-Ferreira PC, Geisler DP, Kiran RP. Benefits of laparoscopy: does the disease condition that indicated colectomy matter? Am Surg 2011; 77:527-533. [PMID: 21679582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The benefits of laparoscopic (LC) over open colectomy (OC) have been well characterized for a variety of conditions. Whether the relative benefits of LC differ for different conditions has not been previously investigated. The aim of this study was to identify whether there are differences in benefits of LC for colon cancer (CC), Crohn's disease (CD), and diverticular disease (DD). Data of patients with CC, CD, and DD undergoing elective colectomy from January 2000 to December 2007 were identified from departmental databases. Patients with CC, CD, and DD undergoing LC were matched 1:1 for diagnosis, gender, body mass index, surgical procedure, American Society of Anesthesiologists scale, and date of surgery to patients undergoing OC. TNM stage was also matched for patients with CC. Two hundred eighty-nine patients undergoing LC (CC, 93; CD, 140; DD, 56) were matched 1:1 to 289 patients undergoing OC. Median age was 49 years (range, 14 to 91 years) in LC and 52 years (range, 14 to 98 years) in OC (P = 0.35). All other matched criteria were also similar in both groups. The conversion rate to OC was 13 per cent (n = 36). Patients undergoing LC had significantly shorter lengths of stay (LOS) (3 days [range, 1 to 70 days] vs 6 days [range, 1 to 37 days], P < 0.001) and lower estimated blood loss (EBL) (100 mL [range, 10 to 1750 mL] vs 200 mL [range, 10 to 1700 mL], P < 0.001). Median operative time was similar in both groups (LC: 145 minutes [range, 35 to 431 minutes] vs OC: 135 minutes [range, 23 to 485 minutes], P = 0.54). The conversion rate was lower for DD (2%) when compared with CC (18.9%) and CD (13.4%). Improvement in EBL with LC was least pronounced in patients with CD and most pronounced in patients with DD (P interaction < 0.001). In the LC group, patients with DD presented less postoperative complications (P = 0.009). LC results in reduced LOS and EBL with similar complications rates when compared with OC. The benefits of LC are more pronounced in DD when compared with CD and CC.
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68
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Fassaert T, Jager G. A round air configuration in the lower abdomen. Neth J Med 2011; 69:245-247. [PMID: 21646674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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69
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Arezzo A, Verra M, Cravero F, Reddavid R, Morino M. How to place hemoclips to achieve hemostasis of a bleeding diverticulum. Dig Dis Sci 2011; 56:1589-90; author reply 1590-1. [PMID: 21416244 DOI: 10.1007/s10620-011-1665-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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70
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Kominami Y, Ohe H, Kobayashi S, Uchida D, Numata N, Matsushita H, Morimoto Y, Nakarai A, Nanba S, Ohta S, Ogawa T, Kurome M, Ueki T, Nakagawa M, Araki Y, Mizuno M. [Dynamic computed tomography is useful for the diagnosis and colonoscopic treatment of colonic diverticular bleeding]. NIHON SHOKAKIBYO GAKKAI ZASSHI = THE JAPANESE JOURNAL OF GASTRO-ENTEROLOGY 2011; 108:223-230. [PMID: 21307626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We investigated whether emergency dynamic computed tomography (CT) is helpful to identify bleeding colonic diverticulum treatable by colonoscopy. We enrolled 95 consecutive patients given diagnoses of colonic diverticular bleeding at Hiroshima City Hospital in the present study, of whom 60 underwent CT before colonoscopy (CT group), and 35 underwent colonoscopy alone (CS group). In the CT group, bleeding diverticula were identified and treated by colonoscopy in 31 of 32 (96.9%) patients in whom extravasation was detected by CT. The interval between bleeding being recognized and CT (median 1.0 hours) in patients in whom extravasation was detected by CT was shorter than that in whom extravasation was not detected (median 5.0 hours). To identify and treat bleeding diverticula by colonoscopy, the use of emergency dynamic CT prior to colonoscopy is recommended.
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71
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Merkow RP, Sun JH. Metastatic adenocarcinoma arising within a diverticulum: endoscopist's nightmare. Am Surg 2011; 77:109-110. [PMID: 21396317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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72
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Rodríguez-Zentner H, Ríos JL, Flamarique A. [Giant colonic diverticulum]. REVISTA DE GASTROENTEROLOGIA DE MEXICO 2011; 76:48-49. [PMID: 21592904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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73
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Marín MR, Candel Arenas MF, Parra Baños PA, González Valverde FM, Garaulet ET, Tamayo Rodríguez ME, Faraco MR, Ros EP, Marín-Blázquez AA. Giant sigmoid diverticulum: a rare complication of a common disease. Am Surg 2011; 77:115-116. [PMID: 21396321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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74
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Catena F, Di Saverio S. Images in clinical medicine. Air in the middle of the abdomen. N Engl J Med 2010; 363:e28. [PMID: 20979466 DOI: 10.1056/nejmicm0804366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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75
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Siddiqui MRS, Sajid MS, Qureshi S, Cheek E, Baig MK. Elective laparoscopic sigmoid resection for diverticular disease has fewer complications than conventional surgery: a meta-analysis. Am J Surg 2010; 200:144-61. [PMID: 20637347 DOI: 10.1016/j.amjsurg.2009.08.021] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 08/17/2009] [Accepted: 08/17/2009] [Indexed: 12/28/2022]
Abstract
BACKGROUND We performed a meta-analysis of published literature comparing the complications after open and laparoscopic elective sigmoidectomy for diverticular disease. METHODS Electronic databases were searched from January 1991 to March 2009. A systematic review was performed to obtain a summative outcome. RESULTS Nineteen comparative studies involving 2,383 patients were analyzed. There were 1,014 patients in the laparoscopic group and 1,369 patients in the open group. There was no significant heterogeneity among any of the complications analyzed. Patients in the laparoscopic sigmoid resection group had fewer wound infections (fixed effects model: risk ratio [RR], .54; 95% confidence interval [CI], .36-.80; z, -3.05; P < .01; random effects model: RR, .59; 95% CI, .39-.89; z, -2.54; P < .05), blood transfusions (fixed effects model: RR, .25; 95% CI, .10-.60; z, -3.10; P < .01; random effects model: RR, .28; 95% CI, .11-.68; z, -2.81; P < .01), and ileus rates (fixed effects model: RR, .37; 95% CI, .20-.66; z, -3.34; P = .001; random effects model: RR, .37; 95% CI, .20-.68; z, -3.21; P = .001) compared with open sigmoid resections. No difference was seen for medical complications, need for rehospitalization, and reoperation. CONCLUSIONS Laparoscopic sigmoid resection is safe and has fewer postoperative surgical complications. This approach should be considered for elective cases, however, more randomized controlled trials are required to strengthen the evidence.
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