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

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Surgical management of diverticulitis is evolving and the decision to offer elective sigmoidectomy for diverticulitis has become more individualized. However, preoperative variables that may predict recurrent diverticulitis after resection and guide surgical decision-making were not well studied.

Methods

This was a retrospective chart review with a prospective questionnaire follow-up of patients. Patients who underwent elective sigmoidectomy for diverticulitis from 2002 to 2016 at a tertiary academic colorectal surgery practice were included and their medical records reviewed. They were then contacted with a questionnaire to inquire about recurrence of diverticulitis since resection. The primary outcome was rate of recurrent diverticulitis after elective sigmoidectomy. The secondary outcome was risk factors for recurrence after sigmoidectomy.

Results

Of 662 patients who underwent elective sigmoidectomy for diverticulitis, 361 had long-term follow-up data available. Mean follow-up was 86 months. Indication for surgery was uncomplicated recurrent diverticulitis in 50%. Recurrent diverticulitis developed in 15 (4.2%) patients. Mean time to recurrence was 55 (range, 6–109) months. All recurrences were confirmed by CT scan. Univariate analysis showed that preoperative diagnosis of irritable bowel syndrome and uncomplicated recurrent diverticulitis was significantly more prevalent in patients who experienced recurrent diverticulitis after sigmoidectomy (p = 0.049 and p = 0.02); however, these variables did not predict recurrence after resection.

Conclusions

Overall rate of recurrent diverticulitis after elective sigmoidectomy was 4.2%. Preoperative diagnosis of irritable bowel syndrome and uncomplicated recurrent diverticulitis was associated with but not significant predictor of recurrence after elective resection.

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Authors and Affiliations

  1. Department of Surgery, Albany Medical Center, 50 New Scotland Avenue, MC-193, Albany, NY, 12208, USA

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

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  1. Karmina K. Choi
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  2. Jessica Martinolich
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  3. Jonathan J. Canete
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  4. Brian T. Valerian
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  5. David A. Chismark
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  6. Ashar Ata
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  7. Edward C. Lee
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Contributions

Concept and design of study: Choi, Canete, Valerian, Chismark, and Lee

Acquisition of data: Choi and Martinolich

Analysis and interpretation of data: Choi, Canete, and Ata

Drafting of article: Choi and Martinolich

Critical revision of article: Canete, Valerian, Chismark, Ata, and Lee

Final approval of the version to be published: all authors

Agreement to be accountable for all aspects of the work: all authors

Corresponding author

Correspondence to Edward C. Lee.

Ethics declarations

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

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Previously presented as an E-poster presentation at the 2018 Annual Meeting of the American Society of Colon and Rectal Surgeons at Nashville, TN, from May 19, 2018 to May 23, 2018.

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Choi, K.K., Martinolich, J., Canete, J.J. et al. Elective Laparoscopic Sigmoid Colectomy for Diverticulitis—an Updated Look at Recurrence After Surgery. J Gastrointest Surg 24, 388–395 (2020). https://doi.org/10.1007/s11605-018-04083-y

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  • DOI: https://doi.org/10.1007/s11605-018-04083-y

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