title: Surgical management of colonic diverticular disease: discrepancy between right- and left-sided diseases.
abstract: OBJECTIVE
  To compare the outcome of the surgical management of left-sided and right-sided diverticular disease.
  
  
  METHODS
  The medical records of 77 patients who were surgically treated for diverticular disease between 1999 and 2010 in a tertiary referral hospital were retrospectively reviewed. The study population was limited to cases wherein the surgical specimen was confirmed as diverticulosis by pathology. Right-sided diverticula were classified as those arising from the cecum, ascending colon, and transverse colon, and those from the descending colon, sigmoid colon, and rectum were classified as left-sided diverticulosis. To assess the changing trend of occurrence of diverticulosis, data were compared with two previous studies of 51 patients.
  
  
  RESULTS
  The proportion of left-sided disease cases was significantly increased compared to the results of our previous studies in 1994 and 2001, (27.5% vs 48.1%, P < 0.05). Moreover, no differences in gender, body mass index, multiplicity of the diverticula, fever, or leukocytosis were noted between patients with right-sided and left-sided disease. However, patients with right-sided disease were significantly younger (50.9 year vs 64.0 year, P < 0.01). Furthermore, left-sided disease was significantly associated with a higher incidence of complicated diverticulitis (89.2% vs 57.5%, P < 0.01), combined resection due to extensive inflammation (21.6% vs 5.0%, P < 0.05), operative complications (51.4% vs 27.5%, P < 0.05), and in-hospital mortality (10.8% vs 0%, P < 0.05), along with longer post-operative hospitalization duration (21.3 ± 10.2 d vs 10.6 ± 8.1 d, P < 0.05).
  
  
  CONCLUSIONS
  Compared with right-sided diverticular disease, the incidence of left-sided disease in Korea has increased since 2001 and is associated with worse surgical outcomes.
authors.affiliation: Heung-Kwon Oh, Eon Chul Han, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Heung-Kwon
authors.initials: HK
authors.lastname: Oh
authors.affiliation: Heung-Kwon Oh, Eon Chul Han, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Eon Chul
authors.initials: EC
authors.lastname: Han
authors.affiliation: Heung-Kwon Oh, Eon Chul Han, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Heon-Kyun
authors.initials: HK
authors.lastname: Ha
authors.affiliation: Heung-Kwon Oh, Eon Chul Han, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Choe
authors.affiliation: Heung-Kwon Oh, Eon Chul Han, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Sang Hui
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Heung-Kwon Oh, Eon Chul Han, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Seung-Bum
authors.initials: SB
authors.lastname: Ryoo
authors.affiliation: Heung-Kwon Oh, Eon Chul Han, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Seung-Yong
authors.initials: SY
authors.lastname: Jeong
authors.affiliation: Heung-Kwon Oh, Eon Chul Han, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Kyu Joo
authors.initials: KJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D003106:Colon / Q000473:pathology / Q000601:surgery*; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D043963:Diverticulosis, Colonic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004241:Diverticulum, Colon / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Colonic diverticulosis; Diverticular bleeding; Diverticulitis; Left-sided diverticulitis; Poor surgical outcome
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