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Recurrent diverticulitis after elective surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Elective sigmoid resection is proposed as a treatment for symptomatic diverticular disease for the possible improvement in quality of life achievable. Albeit encouraging results have been reported, recurrent diverticulitis is still a concern deeply affecting quality of life. The aim of this study is to determine the rate of recurrent diverticulitis after elective sigmoid resection and to look for possible perioperative risk factors.

Methods

Patients who underwent elective resection for DD with at least a 3-year follow-up were included. Postoperative recurrence was defined as left-sided or lower abdominal pain, with CT scan-confirmed findings of diverticulitis.

Results

Twenty of 232 (8.6%) patients developed CT-proven recurrent diverticulitis after elective surgery. All the 20 recurrent diverticulitis were uncomplicated and did not need surgery. Eighty-five percent of the recurrences occurred in patients with a preoperative diagnosis of uncomplicated DD, 70% in patients who had at least 4 episodes of diverticulitis, and 70% in patients with a history of diverticulitis extended to the descending colon. Univariate analysis showed that recurrence was associated with diverticulitis of the sigmoid and of the descending colon (p = 0.04), with a preoperative diagnosis of IBS (p = 0.04) and with a longer than 5 years diverticular disease (p = 0.03). Multivariate analysis was not able to determine risks factors for recurrence.

Conclusion

Our study showed that patients with a preoperative diagnosis of IBS, diverticulitis involving the descending colon, and a long-lasting disease are more likely to have recurrent diverticulitis. However, these variables could not be assumed as risk factors.

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Data availability

All patients were enrolled in the Diverticular Disease Registry (DDR Trial) ClinicalTrials.gov (NCT04907383).

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Author information

Authors and Affiliations

  1. Colorectal Surgery Unit ASST Brianza, Desio Hospital, Desio, Italy

    Mari Giulio, La Porta Angela & Maggioni Dario

  2. University of Milan, Milan, Italy

    Santambrogio Gaia

  3. Colorectal Surgery Unit ASST Lecco, San Leopoldo Mandic Hospital, Merate, Italy

    Costanzi Andrea

  4. University of Udine, Udine, Italy

    Calini Giacomo

  5. Colorectal Surgery Unit, Faenza Hospital, Faenza, Italy

    Montroni Isacco

Authors
  1. Mari Giulio
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  2. Santambrogio Gaia
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  3. Costanzi Andrea
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  4. Calini Giacomo
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  5. La Porta Angela
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  6. Maggioni Dario
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  7. Montroni Isacco
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Contributions

Mari G. and Montroni I. conceived the study; Santambrogio G. wrote the manuscript; Costanzi A., Maggioni D., and Laporta A. collected the data; and Calini G. performed the statistical analysis. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Santambrogio Gaia.

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Ethics approval

This study was approved by the Institutional Review Board of the medical center.

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All patients were enrolled in the Diverticular Disease Registry (DDR Trial) ClinicalTrials.gov (NCT04907383).

Consent for publication

All patients were enrolled in the Diverticular Disease Registry (DDR Trial) ClinicalTrials.gov (NCT04907383).

Conflict of interest

The authors declare no competing interests.

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Giulio, M., Gaia, S., Andrea, C. et al. Recurrent diverticulitis after elective surgery. Int J Colorectal Dis 37, 2149–2155 (2022). https://doi.org/10.1007/s00384-022-04248-x

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