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.
Bibliographical noteFunding Information:
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.
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