Abstract
Objective: To assess current management of diverticulitis in Switzerland.Methods: Prospective observational study of diverticulitis management and outcomes in surgical departments over a 3-month time period. Hospital category was graded according to the Swiss Medical Association (FMH) as: U: University; A: Cantonal; B: Regional; P: Private.Results: 75 participating hospitals treated 1,015 patients, among whom 214 patients (21%) had elective sigmoid resections in 49 hospitals. Indication for elective resection were recurrent diverticulitis, previous complicated diverticulitis, fistulas, and stenosis. Surgeries were performed completely laparoscopically in 185 cases (86%) and required conversion to open in 19 cases (9%). Overall postoperative complication rate was 18% (n = 39) and no mortality was observed. Operation time, surgeons experience and hospital stay differed considerably between hospital categories.Conclusions: Elective sigmoid resection for diverticulitis in Switzerland was mainly performed laparoscopically with low postoperative morbidity. Different practices and outcomes between institutions were observed.
Highlights
Surgical resection was offered after the 2nd or 3rd episode of simple acute diverticulitis, in order to prevent recurrence and more serious forms [1, 2]
This study assessed secondary outcomes of a prospective observational Swiss Snapshot Diverticulitis study which assessed the in-hospital management of colonic diverticulitis in surgical departments in Switzerland over a 3-month time period in 2014 [9]
Indication for elective resection were recurrent diverticulitis, previous complicated diverticulitis, fistulas, and stenosis, which varied between categories of hospitals (Table 1)
Summary
Surgical resection was offered after the 2nd or 3rd episode of simple acute diverticulitis, in order to prevent recurrence and more serious forms [1, 2]. Diverticulitis management changed considerably during the last decade with a more conservative approach in the acute and in recurrent setting, due to evidence on the natural benign course of the disease [5]. The Swiss healthcare system is a public-private mix Health care providers such as doctors and hospitals are partly private and public. Every citizen is obligatorily covered by a basic insurance and pays monthly premiums to the health insurance of his choice. In order to supplement the basic insurance benefits, a citizen can take out an additional private insurance, which covers additional services in hospitals or private clinics, with free choice of location and caregiver.
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