Persistent symptoms after elective sigmoid resection for diverticulitis.
OBJECTIVE
Despite technically successful surgery for diverticular disease, a significant group of patients who experience persistent or recurrent symptoms remains. This study was designed to determine the incidence and pattern of persistent symptoms and their association with peroperative parameters.


METHODS
Follow-up (33 (range, 4-72) months) through structured interviews with patients who had surgery for diverticulitis in our department from December 1999 to November 2004 was conducted. Of 162 patients, 124 (76.5 percent) were available for follow-up. Nonparametric tests were used for comparison of patients who had undergone elective (n = 68) or emergency (n = 56) procedures.


RESULTS
Of patients who had elective surgery, 25 percent suffered persistent symptoms, including painful constipation, painful abdominal distension, abdominal cramps, and frequent painful diarrhea. Neither the stage of disease (complicated or uncomplicated) nor the surgical technique (laparotomy or laparoscopy) were significantly related to the occurrence of symptoms. Recurrent diverticulitis was not observed. Similar results were obtained from comparisons with emergency patients.


CONCLUSIONS
The prevalence of persistent symptoms after successful surgery for diverticular disease may be an additional reason to carefully discuss the indication for prophylactic surgery. In any case, preoperative counseling and informed consent regarding the possibility of persistent symptoms after prophylactic elective surgery is essential.
Egger
Bernhard
B
Department of Visceral and Transplantation Surgery, University of Bern, Bern, Switzerland. bernhard-egger@bluewin.ch
Peter
Matthias K
MK
Candinas
Daniel
D
D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D012809:Colon, Sigmoid / Q000601:surgery*; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology*; D004239:Diverticulitis, Colonic / Q000503:physiopathology / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000503:physiopathology / Q000601:surgery*; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors