Abstract
Summary Background Diverticular disease appears to be one of the most common conditions in the Western world. The standard approach in treatment of diverticular disease is a laparoscopic resection, usually after an inflammation-free time of 4 to 6 weeks. The aim of this study was to evaluate the timing of operation. Materials and methods A total of 61 patients underwent left-sided colonic resection because of diverticular disease between January 2017 and February 2020. Because of complicated diverticulitis (CDD stage 2a or 2b) 37 patients were treated either early within 7 days after first symptoms (group A: n = 17) or delayed about 6 weeks after the first contact and conservative therapy (group B: n = 20). Results Overall mortality was 0%. The average operation time was shorter in the early elective group (group A: 140.4 min vs. group B: 151.2 min; p = 0.29). The hospital stay (group A: 9.9 days vs. group B: 16.9 days) and the postoperative stay (group A: 4.8 days vs. group B: 8.1 days) were significantly longer in group B (p = 0.01). We observed—although not reliable due to the low number of patients—more postoperative complications in the delayed group (group A: 5.9% vs. group B: 15.0%; p = 0.61). Conclusion The data in this study confirm the early operation as safe and efficient due to lower costs. We can recommend an early approach in selected cases with the first episode of a complicated diverticulitis.
Highlights
Diverticular disease was first described in 1928 by Finny et al [1]
After an institutional review board, data were obtained from a retrospectively maintained database of our department. 61 patients underwent laparoscopic leftsided colonic resection because of diverticular disease between January 2017 and February 2020. 37 patients were treated because of complicated diverticulitis according to CDD stage 2a or 2b
We found no intraoperative complications in group A and one patient with a ureteral injury (5.0%) in group B (p = 1.00)
Summary
Diverticular disease was first described in 1928 by Finny et al [1]. Its complications continue to be a burden on health care systems. In the United States the most common gastrointestinal tract diagnoses are diverticulitis and diverticular hemorrhage among hospitalized patients [2, 3]. Diverticular disease appears to be one of the most common conditions in the Western world. Compared to the 1990s, the incidence of diverticulitis increased by 50% from 2000 to 2007 [3]. The prevalence of diverticulosis is about 28–45% and over 60% at the age of 70 years [4]. BMI, and male sex are well-known risk factors for diverticulosis
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