A comparison between laparoscopic and open laparotomy in adults with diverticulitis

Abstract

Overview of the topic: Diverticulitis is a very common disease nowadays. A number of patients attend the emergency department for medical treatment or surgical procedures for diverticulitis in Mater Dei hospital. The aim of this study is to compare open laparotomy and laparoscopic in view of post operation complications. The research question: In adults with diverticulitis undergoing surgery, does laparoscopic procedure compared with open sigmoid colectomy procedure decrease post operation complications? The PICO Model elements used for the search included: Population: Adults with diverticulitis undergoing surgery Intervention: Laparoscopic procedure Comparison: Open sigmoid colectomy procedure Outcome: Decrease post operation complications Inclusion criteria: Studies were included in the review if they met all the coming criteria: (a) fell text and peer-reviewed studies; (b) publication year from 2011-2021; (c) studies including meta-analyses, systematic reviews (SRs) randomised controlled trials (RCTs) and case control studies (CCS); (c) studies in English language; (d) gender neutral; (e) diverticular disease; (f) elective surgery; (g) adults; and (h) no time frame of post operation complications. Exclusion criteria: studies were excluded if they met the coming criteria: (a) robotic approaches; (b) studies including case reports and experts’ opinions; (c) reversal surgery; (d) any other intestinal diseases; (e) non-English language. Search method: The keywords and synonyms from the PICO question were identified and an advanced search was made to eliminate non-related studies. The databases used for the literature search were HyDi, MEDLINE, Pubmed and CINAHL complete. The hierarchy of evidence was used to select the best studies. The inclusion and exclusion criteria were added to exclude more in depth the non-related articles. Furthermore, the critical Appraisal Skills Programme (CASP) tool was used to appraise the studies chosen. Results: A total of 5 articles were included. An RCT, SR, MA and two CCS. All studies showed no significance difference between the laparoscopic procedure and the open procedure, stating that more research needs to be done. Implications and recommendations: A number of implications and recommendations were mentioned because of the lack of information about the two groups locally. Furthermore, health care professionals need to participate in more seminars and workshops to improve their knowledge. Conclusion: In conclusion, Laparoscopic procedure is considered to have less post operation complications comparing to the open procedure.