Our Summary

This research paper looked at the risk of diverticulitis, a digestive disease, recurring after a special type of preventative surgery called prophylactic sigmoidectomy. They examined 364 patients who had this surgery between 2005 and 2019. They found that 7% of these patients experienced a recurrence of the disease about 44 months after surgery.

The study identified two key factors that increased the risk of recurrence: patients who had more than two episodes of diverticulitis before the surgery and patients who were younger than 50 years old. When both these factors were present, the risk of recurrence increased to 18%.

The authors of the study suggest that these findings raise questions about the value of the preventative surgery for patients who fit these risk profiles. They suggest that for these patients, the surgery may not be the best option, because there’s a fairly high chance the disease will come back anyway.

FAQs

  1. What is the recurrence rate of diverticulitis after prophylactic sigmoidectomy surgery?
  2. What factors were identified in the study that increased the risk of diverticulitis recurrence after surgery?
  3. Based on the study findings, is prophylactic sigmoidectomy recommended for all patients with diverticulitis?

Doctor’s Tip

A doctor might tell a patient considering sigmoidectomy for diverticulitis that the surgery may not be the best option if they have had more than two episodes of diverticulitis before the surgery or if they are younger than 50 years old. These factors increase the risk of disease recurrence after the surgery, so the patient should carefully weigh the potential benefits and risks before making a decision. It is important to discuss these findings with your doctor and consider all treatment options available.

Suitable For

Patients who are typically recommended sigmoidectomy are those who have recurrent diverticulitis, particularly those who have had more than two episodes of the disease before the surgery. Additionally, patients who are younger than 50 years old may also be recommended for sigmoidectomy, as they have been found to have an increased risk of disease recurrence. It is important for patients to discuss their individual risk factors and medical history with their healthcare provider to determine if sigmoidectomy is the best course of action for them.

Timeline

Before sigmoidectomy:

  • Patient experiences symptoms of diverticulitis, such as abdominal pain, bloating, and changes in bowel habits.
  • Patient undergoes diagnostic tests, such as a colonoscopy or CT scan, to confirm the diagnosis.
  • Patient and healthcare provider discuss treatment options, including medications, dietary changes, and surgery.
  • Patient decides to undergo sigmoidectomy as a preventative measure to reduce the risk of recurrent diverticulitis.

After sigmoidectomy:

  • Patient undergoes the surgery, which involves removing part of the sigmoid colon where diverticula (small pouches) have formed.
  • Patient recovers in the hospital for a few days, then continues recovery at home.
  • Patient may experience pain, discomfort, and changes in bowel habits during the recovery period.
  • Patient follows a special diet and takes medications as prescribed by their healthcare provider.
  • Patient undergoes follow-up appointments with their healthcare provider to monitor their recovery and assess for any signs of recurrent diverticulitis.
  • In some cases, like the one mentioned in the research paper, the patient may experience a recurrence of diverticulitis despite having undergone sigmoidectomy.

What to Ask Your Doctor

  1. What is the likelihood of recurrence of diverticulitis after undergoing a prophylactic sigmoidectomy?

  2. Are there any specific risk factors that may increase the chances of recurrence after surgery?

  3. How many episodes of diverticulitis prior to surgery would increase the risk of recurrence?

  4. Is age a factor in determining the likelihood of recurrence after prophylactic sigmoidectomy?

  5. Are there alternative treatment options or preventative measures that may be more effective for patients with a history of multiple episodes of diverticulitis or those who are younger than 50 years old?

  6. What are the potential complications or side effects of prophylactic sigmoidectomy?

  7. How long is the recovery period following surgery, and what is the expected outcome in terms of preventing future episodes of diverticulitis?

  8. What post-operative care or follow-up is recommended to monitor for any signs of recurrence?

  9. Are there any lifestyle changes or dietary modifications that can help reduce the risk of diverticulitis recurrence after surgery?

  10. How should patients make an informed decision about undergoing prophylactic sigmoidectomy, considering the risk of recurrence and other factors?

Reference

Authors: Mathilde A, Mege D, Monsinjon M, Giacca M, Panis Y. Journal: Colorectal Dis. 2023 Apr;25(4):757-763. doi: 10.1111/codi.16426. Epub 2022 Dec 4. PMID: 36464948