Surgical outcomes and their relation to the number of prior episodes of diverticulitis.
OBJECTIVE
We aimed to investigate the relationship between the number of prior episodes of diverticulitis and outcomes of sigmoid colectomy.


METHODS
After institutional review board approval, a retrospective review was undertaken based on records of patients who underwent sigmoid resection with anastomosis for diverticulitis between 4 May 2007 and 29 February 2012. Patients were divided into two groups: 0-3 attacks (group 1) and ≥4 attacks (group 2). Statistical analyses were performed to determine whether the groups differed on demographic, intra-operative and postoperative variables.


RESULTS
We identified 247 patients who underwent sigmoid colectomy for diverticulitis (45 open, 202 laparoscopic). The two groups did not differ significantly in age, gender, American Society of Anesthesiologists score, past surgical history, body mass index, length of stay, use of a stoma or number of prior hospitalizations for diverticulitis. Group 1 had a higher rate of abscesses (30.6 vs 6.8%, P < 0.001) and fistulas (19.4 vs 0.9%, P < 0.001); a longer operative time (190.1 vs 166.3 min, P = 0.0024); and higher rates of postoperative complications (45.8 vs 23.3%, P < 0.001) and conversion (17.1 vs 4.4%, P = 0.0091). The most common surgical complications in groups 1 and 2 were wound infection (35 vs 10) and ileus (20 vs 8). Based on multivariate regression analysis, ≥4 attacks were independently correlated with a lower complication rate (odds ratio = 0.512, 95% confidence interval = 0.266-0.987, P = 0.046).


CONCLUSIONS
Patients who had ≥4 previous attacks of diverticulitis had fewer postoperative complications.
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.
Shota
S
Takano
Cesar
C
Reategui
Giovanna
G
da Silva
David J
DJ
Maron
Steven D
SD
Wexner
Eric G
EG
Weiss
diverticulitis; numbers of prior attacks; sigmoidectomy