RESUMO

BACKGROUND: Diverticular disease of the left colon is a common disease, mainly in the population over 50 years of age. The surgical management of acute diverticulitis is remains controversial, especially in severe forms. OBJECTIVE: This study aimed to evaluate the results of laparoscopic surgery for diverticular disease in a tertiary care institution with a specialist interest in minimally invasive surgery. DESIGN: All patients who had elective laparoscopic sigmoidectomy for diverticulitis within eight years at University Hospital of Luxembourg were selected from a retrospective database to evaluate laparoscopic benefit in moderate and severe disease. RESULTS: A total of 155 patients were divided in two groups: Moderate Acute Diverticulitis (MAD) and Severe Acute Diverticulitis (SAD) respectively. The short-term outcomes, after laparoscopic sigmoidectomy, were evaluated. There were not important differences between two groups. CONCLUSIONS: The laparoscopic management of diverticular disease after moderate and severe crisis gives same benefits and short-term outcomes are similar. Elective Laparoscopic surgery is actually the standard of care for moderate and severe diverticular disease in our institution.

Assuntos

Colo Sigmoide/patologia , Colo Sigmoide/cirurgia , Doença Diverticular do Colo/diagnóstico , Doença Diverticular do Colo/cirurgia , Laparoscopia , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Conversão para Cirurgia Aberta , Doença Diverticular do Colo/patologia , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Hospitais Universitários , Humanos , Laparoscopia/métodos , Tempo de Internação , Luxemburgo , Masculino , Pessoa de Meia-Idade , Readmissão do Paciente , Reoperação , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Sigmoidoscopia , Resultado do Tratamento

RESUMO

The purpose of this review is to stress the role of the Mini-Invasive Surgery (MIS) in the treatment of the esophagogastric malignant illnesses, supporting ourselves on the most relevant publications of the literature as well as on our own experience in this subject. In short, although no randomised prospective study has proven the MIS advantages in relation to the traditional surgery in the esophagectomy due to cancer, some authors preferently indicate this approach to selected and informed enough patients, who present the following: - High grade dysplasia, preferently choosing from laparoscopic transhiatal esophagectomy (LTE). - Carcinoma in situ, preferently choosing the LTE vs thoracoscopy. - Esophageal tumour locally advanced, in resectable patients with contraindication for a thoracotomy or, in initially non-resectable patients with tumoral reduction after neo-adjuvant chemo-radiotherapy. The arguments given by the authors are the postoperative spectacular improvement in relation to the comfort and quality of life and, the absence of oncological negative effects in the long-term followup. Concerning gastric cancer, the MIS, as exeresis surgical tool in the so-called <> gastric forms, is such a definite and oncological approach as the traditional approach, and superior to this as far as quality of life is concerned. When the MIS is used for treating locally advanced forms of gastric cancer, it is as safe as the laparotomic way and it seems to obtain the same oncological outcomes in the long-term.

Assuntos

Neoplasias Esofágicas/cirurgia , Esofagoscopia , Gastroscopia , Neoplasias Gástricas/cirurgia , Humanos