title: Smoking increases the incidence of complicated diverticular disease of the sigmoid colon.
abstract: OBJECTIVE
  The aim of this study was to establish whether smoking is associated with complicated diverticular disease and adverse outcomes of operative treatment of diverticular disease. Smoking has been associated with increased rate of perforations in acute appendicitis as well as failure of colonic anastomosis in patients resected for colonic tumours. It has also been suggested that smoking is a risk factor for complicated diverticular disease of the colon.
  
  
  METHODS
  Retrospective investigation of records of 261 patients electively operated for diverticular disease in Helsinki University Central Hospital during a period of five years.
  
  
  RESULTS
  The smokers underwent sigmoidectomy at a younger age than the non-smokers (p = 0.001) and they had an increased rate of perforations (p = 0.040) and postoperative recurrent diverticulitis episodes (p = 0.019).
  
  
  CONCLUSIONS
  We conclude that smoking increases the likelihood of complications in diverticulosis coli. The development of complicated disease also seems to proceed more rapidly in smokers.Key words: Sigmoid resection; laparoscopy; laparoscopic sigmoidectomy; smoking and diverticular disease; complicated diverticular disease; diverticulitis.
authors.affiliation: Department of Gastroenterological and General Surgery, Helsinki University Central Hospital, Helsinki, Finland. pertti.turunen@hus.fi
authors.forename: P
authors.initials: P
authors.lastname: Turunen
authors.forename: H
authors.initials: H
authors.lastname: Wikström
authors.forename: M
authors.initials: M
authors.lastname: Carpelan-Holmström
authors.forename: P
authors.initials: P
authors.lastname: Kairaluoma
authors.forename: O
authors.initials: O
authors.lastname: Kruuna
authors.forename: T
authors.initials: T
authors.lastname: Scheinin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003082:Colectomy; D004241:Diverticulum, Colon / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D012907:Smoking / Q000009:adverse effects*