Elective Laparoscopic Sigmoid Colectomy for Diverticulitis—an Updated Look at Recurrence After Surgery

Choi, Karmina K; Martinolich, Jessica; Canete, Jonathan J.; Valerian, Brian T.; Chismark, David A; Ata, Ashar; Lee, Edward C.

doi:10.1007/s11605-018-04083-y

Cited by 11 publications

(32 citation statements)

References 20 publications

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“…One study [19] was identified by cross-referencing. Finally, six articles [19][20][21][22][23][24] were included in the present review.…”

Section: Studies Selection and Characteristicsmentioning

confidence: 99%

“…From the included studies, five studies were monocentric [19][20][21][22][23] and retrospective observational cohort [19][20][21][22]24] ( Table 1). Overall, 1062 patients were included (518 males and 544 females) with a mean age ranging from 56 to 63 years.…”

Section: Studies Selection and Characteristicsmentioning

confidence: 99%

“…Overall, 1062 patients were included (518 males and 544 females) with a mean age ranging from 56 to 63 years. Data regarding the mean follow-up duration was reported by 4 studies [19][20][21]24], which ranged from 55 to 86 months. Before the surgical procedure, 765 (72%) patients experienced recurrent attacks of diverticulitis, and 128 (12%) presented their first episode (data unavailable for 169 (16%) of cases).…”

Section: Studies Selection and Characteristicsmentioning

confidence: 99%

“…The remaining patients represented 953 (93%) cases, which underwent elective intervention for uncomplicated diverticulitis [19][20][21]24] or complicated diverticulitis [20][21][22]. Other reported indications for surgery were symptomatic diverticulosis [23], persistent abdominal pain/smoldering disease [21,22], recurrent bleeding [22], failure of conservative treatment for diverticulitis [22], and first attack of diverticulitis in immunosuppressed patients [22]. Sigmoidectomy was the procedure of choice in 928 (90%) patients, while anterior resection or left-sided hemicolectomy were not routinely performed (11 patients and 38 patients, respectively; type of intervention performed not reported for 85 patients).…”

Section: Perioperative and Postoperative Outcomesmentioning

confidence: 99%

“…Pathology showed a mean specimen length from 14 to 26 cm [19][20][21][22][23][24] and the presence of diverticulitis in 536 cases, but no inflammation in 177 cases [19][20][21]23] (Table 3). Moreover, inflammation at the proximal margin was reported by two studies in 13 [19] and 30 [24] patients.…”

Section: Perioperative and Postoperative Outcomesmentioning

confidence: 99%

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Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors

Longchamp

Abbassi

Meyer

et al. 2020

Int J Colorectal Dis

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Purpose Fifteen percent of patients undergoing elective sigmoidectomy will present a diverticulitis recurrence, which is associated with significant costs and morbidity. We aimed to systematically review the risk factors associated with recurrence after elective sigmoidectomy. Methods PubMed/MEDLINE, Embase, Cochrane, and Web of Science were searched for studies published until May 1, 2020. Original studies were included if (i) they included patients undergoing sigmoidectomy for diverticular disease, (ii) they reported postoperative recurrent diverticulitis, and (iii) they analyzed ≥ 1 variable associated with recurrence. The primary outcome was the risk factors for recurrence of diverticulitis after sigmoidectomy. Results From the 1463 studies initially screened, six studies were included. From the 1062 patients included, 62 patients recurred (5.8%), and six variables were associated with recurrence. Two were preoperative: age (HR = 0.96, p = 0.02) and irritable bowel syndrome (33.3% with recurrence versus 12.1% without recurrence, p = 0.02). Two were operative factors: uncomplicated recurrent diverticulitis as indication for surgery (73.3% with recurrence versus 49.9% without recurrence, p = 0.049) and anastomotic level (colorectal: HR = 11.4, p = 0.02, or colosigmoid: OR = 4, p = 0.033). Two were postoperative variables: the absence of active diverticulitis on pathology (39.6% with recurrence versus 26.6% without recurrence) and persistence of postoperative pain (HR = 4.8, p < 0.01). Conclusion Identification of preoperative variables that predict the occurrence of diverticulitis recurrence should help surgical decision-making for elective sigmoidectomy, while peri- and postoperative factors should be taken into account for optimal patient follow-up.

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“…One study [19] was identified by cross-referencing. Finally, six articles [19][20][21][22][23][24] were included in the present review.…”

Section: Studies Selection and Characteristicsmentioning

confidence: 99%

Section: Studies Selection and Characteristicsmentioning

confidence: 99%

Section: Studies Selection and Characteristicsmentioning

confidence: 99%

Section: Perioperative and Postoperative Outcomesmentioning

confidence: 99%

Section: Perioperative and Postoperative Outcomesmentioning

confidence: 99%

See 3 more Smart Citations

Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors

Longchamp

Abbassi

Meyer

et al. 2020

Int J Colorectal Dis

View full text Add to dashboard Cite

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Recurrent diverticulitis after elective surgery

Giulio¹,

Santambrogio

Andrea³

et al. 2022

Int J Colorectal Dis

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Incidence of diverticulitis recurrence after sigmoid colectomy: a retrospective cohort study from a tertiary center and systematic review

Waser,

Balaphas,

Uhe

et al. 2023

Int J Colorectal Dis

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Introduction Our aim was to determine the incidence of diverticulitis recurrence after sigmoid colectomy for diverticular disease. Methods Consecutive patients who benefited from sigmoid colectomy for diverticular disease from January 2007 to June 2021 were identified based on operative codes. Recurrent episodes were identified based on hospitalization codes and reviewed. Survival analysis was performed and was reported using a Kaplan–Meier curve. Follow-up was censored for last hospital visit and diverticulitis recurrence. The systematic review of the literature was performed according to the PRISMA statement. Medline, Embase, CENTRAL, and Web of Science were searched for studies reporting on the incidence of diverticulitis after sigmoid colectomy. The review was registered into PROSPERO (CRD42021237003, 25/06/2021). Results One thousand three-hundred and fifty-six patients benefited from sigmoid colectomy. Four hundred and three were excluded, leaving 953 patients for inclusion. The mean age at time of sigmoid colectomy was 64.0 + / − 14.7 years. Four hundred and fifty-eight patients (48.1%) were males. Six hundred and twenty-two sigmoid colectomies (65.3%) were performed in the elective setting and 331 (34.7%) as emergency surgery. The mean duration of follow-up was 4.8 + / − 4.1 years. During this period, 10 patients (1.1%) developed reccurent diverticulitis. Nine of these episodes were classified as Hinchey 1a, and one as Hinchey 1b. The incidence of diverticulitis recurrence (95% CI) was as follows: at 1 year: 0.37% (0.12–1.13%), at 5 years: 1.07% (0.50–2.28%), at 10 years: 2.14% (1.07–4.25%) and at 15 years: 2.14% (1.07–4.25%). Risk factors for recurrence could not be assessed by logistic regression due to the low number of incidental cases. The systematic review of the literature identified 15 observational studies reporting on the incidence of diverticulitis recurrence after sigmoid colectomy, which ranged from 0 to 15% for a follow-up period ranging between 2 months and over 10 years. Conclusion The incidence of diverticulitis recurrence after sigmoid colectomy is of 2.14% at 15 years, and is mostly composed of Hinchey 1a episodes. The incidences reported in the literature are heterogeneous.

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Elective Laparoscopic Sigmoid Colectomy for Diverticulitis—an Updated Look at Recurrence After Surgery

Cited by 11 publications

References 20 publications

Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors

Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors

Recurrent diverticulitis after elective surgery

Incidence of diverticulitis recurrence after sigmoid colectomy: a retrospective cohort study from a tertiary center and systematic review

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