PATIENT SAFETY IN SURGICAL TREATMENT OF COMPLICATED LEFT-SIDED COLONIC DIVERTICULOSIS
Keywords:colonic diverticulosis, laparoscopic Hartmann’s procedure, patient safety
The acute colonic diverticulitis is one of the most common conditions that doctors face, in the emergency medicine. Cases with perforation and generalized peritonitis reach to surgical treatment. These conditions are life-threatening and the emergency surgical care is accompanied with high morbidity and mortality rates. According to literature data, the perioperative mortality in these cases can reach 26%, independently of the choice of surgical method and type of operative intervention. Studies and discussions about patient safety and choice of the best strategy for treatment of the acute complicated diverticulitis of the colon are still topical. The World Society of Emergency Surgery (WSES) published his own guideline for the treatment for this disease in 2016, that was updated in 2020. One of the recommendations is that laparoscopic surgery is safe and fully applicable for the treatment of patients with complicated colonic diverticulosis.
Purpose of our study is to examine the safety and feasibility of laparoscopic surgery in the operative treatment of the complicated left-sided colonic diverticulosis.
In the present abstract we examined the period from January 2015 to January 2020 for operated patients with complicated diverticulosis of the colon, in the Surgical Department of UMHAT ?Eurohospital Plovdiv?. During the mentioned period, 34 patients were operated. Laparoscopic approach was used in 21 of the cases, as conversion was indicated in 4 of them. We used some main criteria to analyze the received data: operative time, early and late complications, and length of hospital stay.
We recommend the laparoscopic approach for complicated diverticulosis as a standard procedure. Applied by an experienced team in selected patients, it leads to favorable perioperative results for the patient, that assure safety and efficacy