Our Summary

This research paper is basically a survey of surgeons in Europe, aiming to understand how they treat a severe gut condition called diverticulitis. There are many ways to treat this condition surgically, and there isn’t a universal standard. The survey was sent to members of the European Association of Endoscopic Surgery and asked them what kind of surgery they would most likely perform on patients with two different levels of severity (Hinchey III and IV) of this condition, both in stable and unstable patients.

The survey found a wide range of responses from the 233 surgeons who answered, coming from countries like Italy, Greece, and the UK. Most of these surgeons had expertise in colorectal surgery. The types of surgeries they would choose included Hartmann’s resection (removing part of the colon), primary resection and anastomosis (removing a part of the colon and then connecting the two ends), and laparoscopic peritoneal lavage (washing out the abdominal cavity), either alone or before the other two types of surgeries.

Depending on the patient’s condition, the surgeons’ preferences for each type of surgery varied widely. For example, for patients with the most severe diverticulitis who are unstable, most surgeons (83.1%) would choose Hartmann’s resection.

This research highlights the need for more awareness and implementation of surgical guidelines for treating diverticulitis, as there is a lot of variation in how it’s currently being treated.

FAQs

  1. What was the purpose of the survey conducted by the European Association of Endoscopic Surgery?
  2. What were the most common types of surgeries chosen by surgeons for treating diverticulitis according to the survey?
  3. What was the main finding of the survey and how does it impact the treatment of diverticulitis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about diverticulitis surgery is to follow all post-operative instructions carefully to ensure proper healing and minimize the risk of complications. This may include instructions on diet, activity level, medication management, and follow-up appointments with the surgeon. It’s important to communicate any concerns or changes in symptoms to the healthcare team promptly.

Suitable For

Patients who are typically recommended diverticulitis surgery are those with severe cases of the condition, specifically those classified as Hinchey III and IV. These patients may have complications such as abscesses, perforations, or fistulas that require surgical intervention. Additionally, patients who are unstable, meaning they are in a critical condition and may not respond well to non-surgical treatments, may also be recommended for surgery.

It is important for surgeons to carefully assess each patient’s individual case and determine the most appropriate course of action based on the severity of their condition and their overall health status. Surgery for diverticulitis should be considered as a last resort when other treatment options have been exhausted or are not effective in managing the condition.

Timeline

Timeline before diverticulitis surgery:

  1. Patient experiences symptoms of diverticulitis such as abdominal pain, bloating, fever, and changes in bowel habits.
  2. Patient undergoes diagnostic tests such as a CT scan or colonoscopy to confirm the diagnosis and determine the severity of the condition.
  3. Patient may be prescribed antibiotics and placed on a clear liquid diet to help reduce inflammation and infection in the colon.
  4. If the condition is severe and not improving with conservative treatment, surgery may be recommended.

Timeline after diverticulitis surgery:

  1. Patient undergoes surgery to remove the affected part of the colon, depending on the severity of the condition and the surgeon’s recommendation.
  2. Patient may stay in the hospital for a few days to recover from surgery and monitor for any complications.
  3. Patient may experience pain, fatigue, and changes in bowel habits as they recover from surgery.
  4. Patient will follow a specific diet and lifestyle recommendations to prevent future episodes of diverticulitis.
  5. Patient will have follow-up appointments with their surgeon to monitor their recovery and address any concerns or complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about diverticulitis surgery include:

  1. What are the different surgical options available for treating my diverticulitis?
  2. How do you determine which type of surgery is the most suitable for my specific condition?
  3. What are the potential risks and complications associated with the surgery?
  4. What is the expected recovery time and post-operative care needed?
  5. Will I need a colostomy or ileostomy after the surgery?
  6. What are the long-term outcomes and potential side effects of the surgery?
  7. Are there any alternative treatments or non-surgical options available for my condition?
  8. How many times have you performed this type of surgery, and what is your success rate?
  9. Will I need any additional tests or consultations before the surgery?
  10. Are there any lifestyle changes or dietary recommendations I should follow after the surgery to prevent future episodes of diverticulitis?

Reference

Authors: Huo B, Massey LH, Seitidis G, Mavridis D, Antoniou SA; EAES Diverticulitis Survey Advisory Group. Journal: Surg Endosc. 2025 Feb;39(2):691-698. doi: 10.1007/s00464-024-11456-9. Epub 2024 Dec 24. PMID: 39719489