Long-term outcome after conservative and surgical treatment of acute sigmoid diverticulitis

Holmer, Christoph; Lehmann, Kai S.; Engelmann, Sabrina; Gröne, Jörn; Buhr, H. J.; Ritz, Jörg‐Peter

doi:10.1007/s00423-011-0815-6

Cited by 31 publications

(34 citation statements)

References 31 publications

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“…Both conservative and surgical treatment of acute episodes of sigmoid diverticulitis are primarily effective in a large percentage of patients, and mortality in both treatment groups is generally low [ 51 ]. However, the recurrence rates and especially the rehospitalization rates are higher in patients treated conservatively than in those undergoing surgery [ 50 , 51 , 52 ].…”

Section: Resultsmentioning

confidence: 99%

Elective Surgery for Sigmoid Diverticulitis - Indications, Techniques, and Results

Jurowich¹,

Germer²

2015

Visc Med

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Diverticulitis is one of the leading indications for elective colonic resections although there is an ongoing controversial discussion about classification, stage-dependent therapeutic options, and therapy settings. As there is a rising trend towards conservative therapy for diverticular disease even in patients with a complicated form of diverticulitis, we provide a compact overview of current surgical therapy principles and the remaining questions to be answered.

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Section: Resultsmentioning

confidence: 99%

Elective Surgery for Sigmoid Diverticulitis - Indications, Techniques, and Results

Jurowich¹,

Germer²

2015

Visc Med

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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%

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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“…They also have low rates of subsequent complicated disease or need for emergency surgery (< 6%). [14][15][16][17][18][19] In addition to this, the estimated risk of needing emergency surgery with stoma formation is 1 in 2,000 patientyears of follow-up. 10 Therefore, elective surgery after the initial attack of simple acute diverticulitis is not recommended nor indicated.…”

Section: Indications For Surgical Management Of Diverticular Disease mentioning

confidence: 99%

Surgical Management of Diverticular Disease in the Elective Setting

Neale

2018

Clinics in Colon and Rectal Surgery

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Diverticulosis is a common condition that has increased in prevalence in industrialized countries over the past century. Estimates of developing diverticular disease in the United states range from 5% by 40 years of age up, to over 80% by age 80. It is estimated that approximately 20% of patients with diverticulosis develop diverticulitis over the course of their lifetime. Diverticular disease can be divided into simple and chronic diverticulitis with various sub categories. There are various instances and circumstances where elective resection is indicated for both complex and simple forms of this disease process. When planning surgery there are general preoperative considerations that are important to be reviewed prior to surgery. There are also more specific considerations depending on secondary problem attributed to diverticulitis, that is, fistula vs stricture. Today, treatment for elective resection includes open, laparoscopic and robotic surgery. Over the last several years we have moved away from open surgery to laparoscopic surgery for elective resection. With the advent of robotic surgery and introduction of 3D laparoscopic surgery the discussion of superiority, equivalence between these modalities, is and should remain an important discussion topic.

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Long-term outcome after conservative and surgical treatment of acute sigmoid diverticulitis

Cited by 31 publications

References 31 publications

Elective Surgery for Sigmoid Diverticulitis - Indications, Techniques, and Results

Elective Surgery for Sigmoid Diverticulitis - Indications, Techniques, and Results

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

Surgical Management of Diverticular Disease in the Elective Setting

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