Laparoscopic Surgery for Acute Right-colon Diverticulitis: Video Vignette and Systematic Review With Meta-analysis of Current Evidence of Minimally Invasive Versus Conventional Surgery.

Abstract

Over the last decade, there has been growing diffusion of minimally invasive surgery in the setting of abdominal emergencies. However, right-colon diverticulitis is still mainly approached by conventional celiotomy. A video vignette is presented showing the details of an emergent laparoscopic right colectomy as performed to treat a 59-year-old woman who presented with clinical signs of peritonitis, and radiologic findings suggestive of acute right-colon diverticulitis complicated by perforation of the hepatic flexure and periduodenal abscess. We also aimed to evaluate the relative outcomes of laparoscopic versus conventional surgery by meta-analyzing the currently available comparative evidence on the argument. A total of 2848 patients were included in the analysis, of which 979 patients received minimally invasive surgery and 1869 had conventional surgery. Laparoscopic surgery had a longer operating time and resulted in an abbreviated hospital stay. Overall, patients receiving laparoscopy had significantly lower morbidity than those whose surgery was undertaken by laparotomy, while there was no statistically significant difference in terms of postoperative mortality. According to the existing literature, minimally invasive surgery improves the postoperative outcomes of patients receiving surgery for right-sided colonic diverticulitis.