Our Summary

This study looked at two types of surgery for severe diverticulitis (an inflammation or infection in one or more small pouches in the digestive tract). The first is called sigmoid resection and primary anastomosis, and the second is the same procedure but with an added step called proximal diversion. The researchers wanted to see if there were any differences in the outcomes of these two surgeries.

They looked at several past studies that included a total of 544 patients. They focused on outcomes like death within 30 days of surgery, serious complications, leakage at the surgical site, needing another operation, and how long the patients stayed in the hospital. They also looked at whether patients ended up needing a permanent stoma (a hole in the abdomen for waste to pass through).

The results showed that there weren’t big differences between the two types of surgery in terms of the outcomes they looked at. However, the chance of needing a permanent stoma was significantly lower for patients who had the first type of surgery.

The authors conclude that both types of surgery have similar outcomes for patients with severe diverticulitis. However, they say that more studies are needed to confirm these findings.

FAQs

  1. What are the two types of surgeries for severe diverticulitis that the study examined?
  2. What were the main outcomes the researchers focused on in the study?
  3. Was there a difference in the chance of needing a permanent stoma between the two types of surgeries?

Doctor’s Tip

A doctor might advise a patient undergoing diverticulitis surgery to discuss the option of sigmoid resection and primary anastomosis with their surgeon, as it may reduce the risk of needing a permanent stoma compared to the alternative procedure. It’s important for patients to have a thorough discussion with their healthcare team to understand the potential risks and benefits of each surgical approach.

Suitable For

Patients with severe diverticulitis who have not responded to other treatments, such as antibiotics or a liquid diet, may be recommended for surgery. Patients who have complications such as abscesses, fistulas, or bowel obstruction may also be candidates for surgery. Additionally, patients who have recurrent episodes of diverticulitis or who have a high risk of complications from the condition may be recommended for surgery. Ultimately, the decision to undergo surgery for diverticulitis is based on the individual patient’s specific circumstances and the recommendation of their healthcare provider.

Timeline

Before diverticulitis surgery, a patient typically experiences symptoms such as abdominal pain, bloating, nausea, fever, and changes in bowel habits. They may undergo diagnostic tests such as a CT scan or colonoscopy to confirm the diagnosis.

After surgery, the patient will go through a recovery period in the hospital, which can last several days to a week or more depending on the type of surgery and any complications that may arise. They will be monitored for signs of infection, leakage at the surgical site, and other potential complications.

Once discharged from the hospital, the patient will need to follow a specific diet to allow the digestive tract to heal properly. They may also need to take pain medication and antibiotics to prevent infection.

Over time, the patient will gradually resume normal activities and may need to make dietary and lifestyle changes to prevent future episodes of diverticulitis. Follow-up appointments with the surgeon or gastroenterologist will be scheduled to monitor recovery and address any concerns.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with diverticulitis surgery?
  2. What is the success rate of the surgery in terms of resolving diverticulitis symptoms?
  3. How long is the recovery process expected to be and what can I expect during the recovery period?
  4. Will I need to make any lifestyle changes or follow a special diet after the surgery?
  5. What are the chances of needing a permanent stoma after the surgery?
  6. Are there any alternative treatment options to surgery that I should consider?
  7. How experienced is the surgical team in performing this specific type of surgery?
  8. What is the expected outcome in terms of pain management and overall quality of life post-surgery?
  9. Will I need any follow-up appointments or additional treatments after the surgery?
  10. Are there any specific factors or conditions that could impact the success of the surgery in my case?

Reference

Authors: Dreifuss NH, Casas MA, Angeramo CA, Schlottmann F, Laxague F, Bun ME, Rotholtz NA. Journal: Surgery. 2023 Aug;174(2):180-188. doi: 10.1016/j.surg.2023.04.035. Epub 2023 May 29. PMID: 37258308