Surgery For Diverticulitis Research Articles

Long-term Follow-up After an Initial Episode of Diverticulitis: A 13- Year Update.

For patients with recurrent diverticulitis, the trigger to proceed to elective sigmoid colectomy is unclear. Current clinical practice guidelines suggest this is an individualized decision between surgeon and patient. To assess long-term risk of diverticulitis recurrence and determine predictors of recurrent disease. Retrospective case series. Tertiary care center. Consecutive patients with CT-proven diverticulitis who presented as inpatient or outpatient between 2002-2008. Incidence of diverticulitis recurrence determined via chart review and questionnaire. Risk of recurrent diverticulitis or surgery for diverticulitis. A total of 753 patients with first-time diverticulitis were identified. Patients were 61.5 years old (SD 15.3). Median follow-up was 13.2 years (IQR 3.8-18.3). There were 486 (64.5%) patients alive at time of follow-up. During initial presentation, 29 (3.9%) required IR drainage and 37 (4.9%) required emergency surgery. Forty-three (5.7%) underwent elective surgery after initial presentation, and 77 (10.2%) underwent surgery after more than 1 episode. Of those without surgery for first episode, 353 (52.4%) experienced recurrent disease with median time to recurrence of 2.9 years (IQR 0.83-8.5 years). On multivariate analysis, female sex (HR 1.28, p = 0.04), sigmoid disease (HR 1.35, p = 0.03), smoldering disease (HR 3.17, p < 0.01), length of involved segment >5 cm (HR 1.28, p = 0.04), and maximum fat stranding diameter >1.8 cm (HR 1.29, p = 0.03) were associated with disease recurrence. Kaplan Meier estimates of freedom from recurrence were 73.1% (69.6-76.3%) at 1 year, 47.9% (44.0-51.6%) at 5 years, and 34.6% (31.0-38.2%) at 10 years following initial presentation. Retrospective design. After a single episode of diverticulitis, incidence of recurrence is more than 50% on long-term follow-up. Variables such as female sex, sigmoid disease, smoldering disease, length of involved segment greater than 5 cm, and maximum fat stranding diameter greater than 1.8 cm were associated with an increased risk of recurrence. These findings should be considered when counseling patients on decision to proceed with elective colectomy. See Video Abstract.

An evaluation of patient experience before and after elective colectomy for diverticulitis between patients older and younger than 65 years: A pilot feasibility study in mobile health use

BackgroundMobile health (mHealth) platforms are being used to understand patient-reported experiences before and after surgery. Currently, there is limited literature describing the feasibility of using mHealth to evaluate patient experience among older adults. The objective of this study was to determine the feasibility of using mHealth to evaluate patient-reported outcomes among patients older and younger than 65 years undergoing elective colectomy for diverticulitis. MethodsA prospective pilot study was performed between June 1, 2020 and August 31, 2021, enrolling patients aged > 18 years undergoing elective colectomy for diverticulitis at a single academic center (n = 62). A Health Insurance Portability and Accountability Act-compliant mHealth platform was used to deliver patient-reported quality-of-life surveys at 3 time points: preoperatively, 3 months postoperatively, and 6 months postoperatively. The primary outcome was the feasibility of using mHealth in patients older and younger than 65 years to collect outcomes using recruitment, engagement, and survey completion rates. Preliminary findings of patient experiences were evaluated for patients older and younger than 65 years as secondary outcomes. ResultsOverall, 33.9% of participants were older than 65 years with a median age of 59.8 years (IQR, 53.3–67.9). mHealth enrollment was high (100%) with survey response rates of 79% preoperatively, 64.5% at 3 months postoperatively, and 17.7% at 6 months postoperatively. Response rates were similar among patients older and younger than 65 years (P = .79 preoperatively and P = .39 at 3 months postoperatively). ConclusionUtilization of mHealth to evaluate patient-reported outcomes is feasible in the preoperative and early postoperative settings, including older adults undergoing elective surgery for diverticulitis. Future work will focus on improving long-term outcomes to better examine potential differences when considering patient-centered outcomes among older adult patients.

Diverticulitis Surgery Outcomes: Insights from Our Clinical Practice

Aim: To assess outcomes of diverticulitis surgery, focusing on various patient phases at a tertiary center and incorporating literature insights. Materials and Method: Analysis included diverticular disease surgeries at *** University's General Surgery Clinic over five years, examining demographics, disease specifics, surgical details, stoma aspects, and complications. Patients were categorized into emergency and elective groups for comparison based on Hinchey scores and stoma status. Results: Of the patients, 72% were male, with an average age of 58.46. The sigmoid colon was predominantly affected (84%). Percutaneous drainage was used preoperatively in 44%, and 56% required a stoma, primarily Hartmann colostomies (36%). The median stoma closure time was 5 months, with 10 patients unable to have their stoma closed. Emergency surgeries were associated with higher Hinchey stages (III-IV) and an increased need for stoma creation (81% vs. 16% in elective surgeries). Conclusion: The study indicates a median 5-month duration for stoma reversal, with sigmoid colon being the common site regardless of gender. Emergency surgeries showed a higher rate of stoma creation, suggesting elective surgeries could reduce stoma necessity. Further investigation is needed for broader applicability.

Stenosis of the colorectal anastomosis after surgery for diverticulitis: A national retrospective cohort study.

The aim of this work was to investigate the association between early postoperative anastomotic leakage or pelvic abscess (AL/PA) and symptomatic anastomotic stenosis (SAS) in patients after surgery for left colonic diverticulitis. This is a retrospective study based on a national cohort of diverticulitis surgery patients carried out by the Association Française de Chirurgie. The assessment was performed using path analyses. The database included 7053 patients operated on for colonic diverticulitis, with surgery performed electively or in an emergency, by open access or laparoscopically. Patients were excluded from the study analysis where there was (i) right-sided diverticulitis (the initial database included all consecutive patients operated on for colonic diverticulitis), (ii) no anastomosis was performed during the first procedure or (iii) missing information about stenosis, postoperative abscess or anastomotic leakage. Of the 4441 patients who were included in the final analysis, AL/PA occurred in 327 (4.6%) and SAS occurred in 82 (1.8%). AL/PA was a significant independent factor associated with a risk for occurrence of SAS (OR = 3.41, 95% CI = 1.75-6.66), as was the case for diverting stoma for ≥100 days (OR = 2.77, 95% CI = 1.32-5.82), while central vessel ligation proximal to the inferior mesenteric artery was associated with a reduced risk (OR = 0.41; 95% CI = 0.19-0.88). Diverting stoma created for <100 days or ≥100 days was also a factor associated with a risk for AL/PA (OR = 3.08, 95% CI = 2-4.75 and OR = 12.95, 95% CI = 9.11-18.50). Interestingly, no significant association between radiological drainage or surgical management of AL/PA and SAS could be highlighted. AL/PA was an independent factor associated with the risk for SAS. The treatment of AL/PA was not associated with the occurrence of anastomotic stenosis. Diverting stoma was associated with an increased risk of both AL/PA and SAS, especially if it was left for ≥100 days. Physicians must be aware of this information in order to decide on the best course of action when creating a stoma during elective or emergency surgery.

Does Hispanic ethnicity play a role in outcomes for diverticular surgery in the USA?

ObjectiveThe aim of this study is to investigate whether origins of ethnicity affect the outcomes of surgery for diverticulitis in the USA.DesignThe American College of Surgeons National Surgical Quality Improvement...

Lending a hand: The utility of hand-assisted laparoscopic surgery in diverticulitis with fistula

BackgroundCurrent guidelines recommend elective colectomy for the management of diverticulitis-associated fistulas. These cases present considerable operative challenges, and surgical approaches and fistula tract management vary widely. Hand-assisted laparoscopic surgery offers the benefits of minimally invasive surgery while maintaining the tactile advantages of open surgery. This study aims to evaluate outcomes of hand-assisted laparoscopic surgery colectomy for diverticulitis-associated fistulas, fistula tract, and urinary catheter management. MethodsA retrospective review of patients with diverticulitis-associated fistula who underwent elective hand-assisted laparoscopic surgery colectomy between January 2, 2008, and September 8, 2022, was performed. Patients with Crohn disease or who underwent emergency surgery were excluded. ResultsSeventy patients were included; the mean patient age was 64.1 ± 14.8 years, and the mean body mass index was 30.9 ± 9.1 kg/m2. Colovesical fistulas were most common (n = 48; 68.6%), followed by colovaginal fistulas (n = 22; 31.4%). The median operative time was 186 minutes. Conversion to an open approach occurred in 4 cases (5.7%). The fistula tract remnant was left without intervention in 35 patients (50%), and omental coverage occurred in 23 cases (32.9%). The median duration of the urinary catheter was 3 days (range = 1–63). There were no postoperative urine leaks. Three patients (4.3%) were readmitted in ≤30 days. There were no 30-day mortalities. ConclusionThe challenges of colectomy for diverticulitis-associated fistulas can be mitigated using the hand-assisted laparoscopic surgery technique. We found a low conversion-to-open rate, falling below rates reported for laparoscopic colectomy. There were no cases of postoperative urine leak, suggesting that no intervention or omental coverage is a safe approach to fistula tract management.

Is the Hartmann's procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 2018.

Historically, Hartmann's procedure (HP) has been the operation of choice for diverticulitis in the emergency setting. However, recent evidence has demonstrated the safety of primary anastomosis (PA) with or without diverting ileostomy. The purpose of this study was to evaluate the trends of, and factors associated with, HP compared to PA in emergency surgery for diverticulitis over 25years. Using the National Inpatient Sample database, we identified adult patients ≥ 18years old who underwent emergency surgery for diverticulitis (HP or PA) between 1993 and 2018 using ICD-9 and ICD-10 codes. Patients with inflammatory bowel disease, gastrointestinal cancer or who underwent elective diverticulitis surgery were excluded. Trends in HP were analyzed using multivariable linear regression, and factors associated with HP were assessed with multiple logistic regression. Of 499,433 patients who underwent colectomy in the emergency setting for acute diverticulitis, 271,288 (54.3%) had a HP and 228,145 (45.7%) had a PA. Median age was 61years (IQR: 50-73), 53% were women, and 70.5% were white. The proportion of HP slightly increased over the study period-HP comprised 52.6% of included cases in 1993-98 and 55.2% of cases in 2014-2018 (p = 0.017). Advanced age (reference = 18-44years; 45-54years: OR 1.16, 95% CI 1.10-1.22; 55-64years: OR 1.26, 95% CI 1.20-1.33; 65-74years: OR 1.33, 95% CI 1.25-1.42; ≥ 75years: OR 1.51, 95% CI 1.41-1.62), complicated diverticulitis (OR 1.41, 95% CI 1.36-1.46), and severity of illness (reference = minor; moderate: OR 1.46, 95% CI 1.38-1.54; major/extreme: OR 3.43, 95% CI 3.25-3.63) were associated with increased odds of HP. Over a 26-year period, HP has remained the most performed procedure in the emergency setting for diverticulitis. Future work should focus on knowledge translation with a possible change in practice as more randomized controlled trials provide support for PA.

Effects of sarcopenia and myosteatosis are alleviated in reduced port surgery for diverticulitis

PurposeMany studies report the predictive value of sarcopenia, myosteatosis, and visceral fat for clinical outcome after surgery. Radiological analysis of body composition is a valuable tool for identifying high-risk patients undergoing major abdominal surgery. Despite the high prevalence of diverticular disease, patients with benign conditions have hardly been studied in this context. This study aims to evaluate the impact of reduced port surgery on the outcome of patients with diverticulitis, adjusting for body composition.MethodsWe assessed body composition profiles using preoperative CT slices at the level of the third lumbar vertebra in consecutive patients undergoing single-port elective surgery for diverticulitis in a single center. The effects of sarcopenia, myosteatosis, and visceral fat on mortality and complications were analyzed and adjusted for age and gender.ResultsWe enrolled 99 patients with diverticulitis undergoing elective single port surgery in this study. Of the patients, 71.2% had sarcopenia and 60.6% had myosteatosis. The overall complication rate was 17.2%, and the rate of anastomotic leakage was 4.0%. Thirty-day mortality was 2.0%. Loss of skeletal muscle mass, myosteatosis, and visceral fat were not associated with higher complication or mortality rates in our cohort.ConclusionBody composition profiles had no impact on the clinical course in our cohort. Minimally invasive surgery may potentially compensate for the adverse effects of sarcopenia and myosteatosis in diverticulitis.

The Impact of the COVID Pandemic on Diverticulitis Surgery

Arnott, Suzanne M MD; Haviland, Sarah MD; Ng, Matthew MD; Obias, Vincent J MD Author Information

Recurrent Lower Abdominal Pain, Altered Bowel Habits, and Malaise: Conservative or Surgical Approach to a Common Disorder

Recurrent Lower Abdominal Pain, Altered Bowel Habits, and Malaise: Conservative or Surgical Approach to a Common Disorder

Navigation for the ureter using a novel near-infrared light catheter during laparoscopic surgery for diverticulitis

Navigation for the ureter using a novel near-infrared light catheter during laparoscopic surgery for diverticulitis

Clinical and Demographic Characteristics of Young Patients Requiring Surgery for Diverticulitis

Introduction: Diverticulitis is a common gastrointestinal diagnosis. Diverticulitis is as increasing for all demographics, and the rise has been greatest for the younger subgroup. This study aimed to characterize the clinical and demographic features associated with patients ≤40 years needing surgery after their index episode of diverticulitis. Methods: Retrospective review of patients undergoing surgical intervention for index episode of diverticulitis from 2015 to 2021 at a single tertiary care center. Patients ≤40 years were compared with a control group consisting of patients >40 years old. Results: The analysis included 62 patients; 21 patients ≤40 years old (mean age 32.7 years) and 41 controls >40 years old (mean age 57.8 years); p = 0.001. Patients ≤ 40 years were more likely to be male (71.4% vs 34%, p = 0.005), Hispanic (66.7% vs 34.1%, p = 0.019), and obese (71.4% vs 29.3%, p = 0.017) with a greater mean BMI (32.9 kg/m2 vs 28.2 kg/m2, p = 0.002). The most likely indication for surgery in the ≤40 group was recurrent disease (38.1%), while the most common indication in the >40 group was development of a fistula (31.7%); p = 0.734. There was no difference in overall postoperative complication or readmission. Conclusion: We see an increasing proportion of advanced diverticulitis in the young population and our study demonstrates that the characteristics of this group differs from older patients. Further work to elucidate potential social, environmental, and biological etiologies of these findings is warranted.

Is laparoscopic surgery safe for elderly patients with diverticulitis? A national database study

Laparoscopy is the preferred approach to elective surgery for diverticulitis and is increasingly common in the emergent setting. Although diverticulitis is most prevalent among older adults, little is known about the safety of laparoscopy for elderly patients with diverticulitis. This study aims to compare 30-day outcomes of a laparoscopic versus open approach for diverticulitis among elderly patients undergoing elective and urgent/emergent surgery. Patients ≥ 65years who underwent surgery for diverticulitis from 2015 to 2019 were identified from the ACS-NSQIP database. Elective and non-elective groups were analyzed separately. Coarsened exact matching matched laparoscopic and open patients 1:1 based on preoperative factors to minimize selection bias by creating comparable cohorts. Short-term outcomes of laparoscopic versus open surgery were compared. A total of 15,316 patients were included, 69.2% female and 88% White, with a mean age of 72.7 ± 6.1years. Approximately half (50.9%) of cases were laparoscopic and 60.6% were elective. After matching, laparoscopy was associated with lower 30-day morbidity in both the elective (OR, 0.47; 95%CI, 0.38-0.58) and non-elective (OR, 0.76; 95%CI, 0.58-0.98) cohorts. Laparoscopic surgery in both cohorts was associated with fewer surgical site infections (SSIs) (elective, OR 0.43; 95%CI, 0.33-0.57; non-elective, OR, 0.66; 95%CI, 0.44-0.98) and shorter length of stay (LOS) (elective, mean difference, 1.7days; 95%CI, 1.5-1.9; non-elective, mean difference, 1.2days; 95%CI, 0.43-2.1). Elderly patients undergoing both elective and non-elective laparoscopic surgery for diverticulitis have less 30-day morbidity, SSIs, and shorter LOS compared to an open approach. Therefore, laparoscopy for elderly patients is safe in elective surgery and in select emergent cases as well.

Impact of the first COVID-19 surge on the outcomes of diverticulitis.

IntroductionDuring the first surge of the COVID-19 pandemic, healthcare utilization changed. We sought to examine the impact of the first COVID-19 surge on the outcomes of patients whose elective surgeries for diverticulitis were postponed and those who underwent urgent surgery during the surge.Materials and methodsThis was a retrospective study from a single tertiary center in the Northeast of the US. Patients whose elective surgeries were delayed, or who underwent urgent surgery for diverticulitis during the first COVID-19 surge (3/16/2020 to 8/1/2020) were included. A cohort from 2019 was used for comparison. Variables were compared between groups including: procedure, death, length of stay, disposition, stoma rate, technique for surgery, and leak rate.ResultsForty-five patients were included in the COVID-19 group and 44 patients in the 2019 group. Twenty-seven patients had elective surgeries delayed during the COVID-19 surge. Ten (37%) required more urgent surgery, 80% with complicated disease. Six (22%) were admitted to the hospital and 13 (48%) required additional antibiotics. Eight (30%) patients postponed their surgeries indefinitely and 7 (26%) had surgery once permitted. There were no observed differences between the two groups in the rate of complicated disease, leaks, technique for surgery or stoma rate.ConclusionsDuring the first COVID-19 surge, over 1/3 of patients whose elective diverticulitis surgeries were postponed required urgent surgery, a majority of whom had complicated disease. There were no apparent differences in outcomes when compared to a pre-pandemic cohort, highlighting the importance of a triage system with the ability to escalate surgery in a timely manner.

Dependent functional status is a risk factor for complications after surgery for diverticulitis coli

BackgroundFunctional dependence (FD) is associated with poor postoperative outcomes. We investigated the influence of FD on the postoperative outcomes of colectomy. MethodsThe 2012–2020 National Surgical Quality Improvement Program was queried for patients who had undergone colectomy for diverticulitis. The patients were analyzed based on FD or functionally independent (FI) status. ResultsOf the 62,409 patients 991 (1.6%) were FD. Compared to FI patients, those with FD were older (mean age, 72.7 vs. 59.1 years, p < 0.001), with higher comorbidities and more unplanned open procedures (79.7% vs. 38.0%, p < 0.001). After adjusting for American Society of Anesthesia status, age, and comorbidities, the FD patients were 1.12 times (95% CI:1.07–1.17) more likely to have postoperative morbidity and 1.53 times (95% CI: 1.2–1.82) more likely to have 30-day mortality. ConclusionsDependent functional status is an independent risk factor for complications after surgery for diverticulitis.

Multi-institutional Cohort Study of Elective Diverticulitis Surgery: a National Surgical Quality Improvement Program Database Analysis to Identify Predictors of Non-home Discharge Among Older Adults

BackgroundOlder adults often prioritize independence and time spent at home when making major treatment decisions. Identifying preoperative predictors of non-home discharge (i.e., requiring institutional discharge rather than home), among adults undergoing elective diverticulitis surgery, can support surgical decision-making and expectation management. This study aims to (1) examine rates of non-home discharge after elective surgery for diverticulitis and (2) identify predictors of non-home discharge. MethodsThis is a multi-institutional cohort study of National Surgical Quality Improvement Program Database. Patients over 18 years who underwent colon resection with diagnosis of diverticulitis were included. Clinical and demographic information were collected by trained nurse reviewers. Emergency operations were excluded. Patients with home versus non-home discharge were compared and predictors identified using multivariable regression. ResultsBetween 2016 and 2019, 40,912 patients were identified. Mean age was 58.5 years (SD=12.58) with 48.5% 60+years and 17.7% of patients 70+years old. The majority (55.9%) were female and “White” race (83.5%). Most patients underwent colectomy without ostomy (88.4%). Nine percent of patients over age 60 had non-home discharge. Functional dependence preoperatively was strongly associated with non-home discharge. On multivariable analysis, significant predictors of non-home discharge were preoperative functional dependence (OR 28.2; 95% CI 9.8–81.7), advancing chronologic age (age 80+: OR 22.4; 95% CI 18.6–26.9), and preoperative albumin<3.0 (OR 4.0; 95% CI 3.4–4.6). ConclusionsNearly one in ten patients over 60 years was not discharged home after elective diverticulitis surgery. Preoperative functional status predicts non-home discharge. Future studies need to assess potentially modifiable causes of non-home discharge, such as social support.

An international multi-institutional analysis of operative morbidity in patients undergoing elective diverticulitis surgery.

We investigated surgical complications of elective surgery for diverticulitis in international multi-institution to identify a prediction model for potential opportunities of quality improvement. We identified 1225 patients who underwent elective surgery for diverticulitis between January 2010 and January 2018. The data were obtained from the National Surgical Quality Improvement Program and the Turkish Diverticulitis Study Group Collaborative, retrospectively. We observed that the presence of chronic obstructive pulmonary disease (OR: 3.2, 95%CI 1.8-5.9, p<0.001) or abscess at the time of surgery (OR: 1.4, 95%CI 1.2-1.7, p£0.001) is associated with a higher rate of minor complications, while comorbidities such as dyspnea (OR: 2.8, 95%CI 1.6-4.9, p£0.001) and preoperative sepsis (OR: 4.1, 95%CI 2.3-7.3, p£0.001) are associated with major complications. The centers had similar findings in minor and major complications (OR: 0.8, 95%CI 0.5-1.4, p=0.395). The major independent predictors for complications were malnutrition (low albumin) (OR: 0.5, 95%CI 0.4-0.6, p<0.001) and the American Society of Anesthesiology score (OR: 1.7, 95%CI 1.2-2.4, p=0.002). Regarding the major and minor complications of diverticulitis of elective surgery, the malnutrition and higher American Society of Anesthesiology score showed higher impact among the quality improvement initiatives.

Emergency Surgery for Diverticulitis: Relationship of Outcomes to Patient Age and Surgical Procedure.

To compare outcomes in emergent surgical treatment of acute diverticulitis in the older population. Retrospective multi-institute database cohort analysis. American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) and NSQIP Colectomy Targeted Database. The American College of Surgeons National Surgical Quality Improvement Project Colectomy Targeted Database was merged with the main participate use file to identify adult patients undergoing emergent Hartmann procedure or primary anastomosis with diverting loop ileostomy for acute diverticulitis. Patients were subdivided into age cohorts (<65years, 65-79years, ≥80years) and primary postoperative outcomes including mortality, morbidity, and readmission were compared using multivariate regression. A total of 6091 patients were identified. On multivariate analysis, 30-day mortality was higher in patients undergoing a Hartmann procedure aged 65-79years [odds ratio (OR) 2.39, P < .001] and ≥80years (OR 6.28, P < .001) compared to patients aged <65years. In patients undergoing a primary anastomosis with diverting loop ileostomy, 30-day morbidity was lower only in the cohort aged ≥80years (OR 2.63, P= .04). Readmission rates were similar across age groups within each procedure cohort. Comparing the 2 procedures, readmission rates in patients aged 65-79years who underwent a Hartmann procedure were lower than those that underwent a primary anastomosis with diverting loop ileostomy (OR 2.43, P= .001). In patients aged ≥80years, readmission rates were lower in patients who underwent a primary anastomosis with diverting loop ileostomy (OR 0.12, P= .04). Thirty-day mortality was also lower in patients aged ≥80years if they underwent a primary anastomosis with diverting loop ileostomy (OR 0.15, P= .03) but similar for patients aged 65-79years (OR 0.81, P= .70). In patients undergoing a Hartmann procedure emergently for diverticulitis, mortality is higher in older patients. Patients aged ≥ 80years had increased mortality if they underwent a Hartmann procedure compared to a primary anastomosis with diverting ileostomy; however, readmission rates vary with procedure performed. Careful consideration of age should be taken into account when operating emergently for diverticulitis.

Essential updates 2020/2021: Colorectal diseases (benign)-Current topics in the surgical and medical treatment of benign colorectal diseases.

The development of new drugs for inflammatory bowel disease (IBD) is remarkable, and treatment strategies using multiple agents and various techniques are required; however, the treatment strategy is likely to be complex. Therefore, appropriate evaluation of traditional surgical treatment strategies and accurate knowledge of the efficacy and limitations of novel treatments are required. Total infectious complications were found to be associated with the use of corticosteroids and anti‐tumor necrosis factor‐α agents, but not with immunomodulators, anti‐integrin agents, and 5‐aminosalicylic acid. Regarding surgical procedures for IBD, conceived anastomosis methods, including Kono‐S for Crohn's disease stenosis, are associated with better outcomes than conventional techniques. Autologous cell transplantation for Crohn's fistulae has been shown to have a favorable outcome. Diverticulitis is increasing and will be treated more frequently in the future. Risk factors for the incidence of diverticulitis and differences in pathogenesis according to right or left side diverticulitis have been reported. Antibiotic therapy may be omitted for uncomplicated diverticulitis. Moreover, regarding surgical procedures, both bowel resection and anastomosis are associated with favorable short‐term outcomes, higher stoma closure rate, and superior medical economy compared to Hartmann's procedure. Risk factors for recurrence after diverticulitis surgery may provide better postoperative follow‐up. In this review, we explore the current topics of colorectal benign diseases, focusing on IBD and diverticulitis, based on clinical trials and meta‐analyses from 2020‐2021. This review consolidates the available knowledge and improves the quality of surgical procedures and perioperative management for IBD and diverticulitis.

Elective Surgery for Diverticulitis in Swiss Hospitals.

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.