World Journal of Surgery

, Volume 31, Issue 2, pp 383–387 | Cite as

Critical Appraisal on the Role and Outcome of Emergency Colectomy for Uncomplicated Right-sided Colonic Diverticulitis

  • Wing-Wa Leung
  • Janet FY Lee
  • Shirley YW Liu
  • Jennifer WC Mou
  • Simon SM Ng
  • Raymond YC Yiu
  • Jimmy CM Li
Article

Abstract

Background

Emergency colectomy is well accepted for treating complicated right-sided colonic diverticulitis. However, the role of colectomy for uncomplicated diverticulitis is not well defined. The aim of this study was to evaluate the short-term and long-term surgical outcome of uncomplicated right-sided diverticulitis in our locality.

Patients and Methods

Retrospective chart review of patients operated for right-sided diverticulitis over a 20-year period was conducted. Recurrent attacks of right-sided diverticulitis, re-operation rate and re-hospitalisation rate were the long-term parameters of interest. An updated telephone interview was carried out for all surviving patients.

Results

Seventy-four patients (35 males and 39 females), median age 35.5 (range 16–70) years, were operated for uncomplicated diverticulitis. Thirty patients underwent colectomy, whereas the others underwent appendectomy with diverticulectomy (n = 8) or appendectomy alone (n = 36). All short-term parameters were less favourable for the colectomy group, including higher complication rate, slower return of gastrointestinal function, higher requirement of parenteral analgesic and longer hospital stay. Without colectomy, only 2 patients developed recurrent diverticulitis necessitating hospitalisation, both of whom resolved on conservative treatment. On the other hand, 1 patient required re-operation after colectomy because of intestinal obstruction. The overall re-hospitalisation rate was comparable between the colectomy and the non-colectomy group (16.7% vs. 13.6%).

Conclusions

Emergency colectomy can eradicate suspicious lesions and eliminate risk of recurrent diverticulitis but at the expense of higher morbidity rates. As the natural course of uncomplicated right-sided colonic diverticulitis is usually benign, conservative treatment with minimal surgery may be a better therapeutic option.

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Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • Wing-Wa Leung
    • 1
  • Janet FY Lee
    • 1
  • Shirley YW Liu
    • 1
  • Jennifer WC Mou
    • 1
  • Simon SM Ng
    • 1
  • Raymond YC Yiu
    • 1
  • Jimmy CM Li
    • 1
  1. 1.Department of SurgeryThe Chinese University of Hong Kong, Prince of Wales HospitalHong KongChina

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