Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH
Elective sigmoidectomy is associated with improved quality of life for patients with recurrent and persistent symptoms after a diverticulitis episode, suggests an open-label trial in the Lancet Gastroenterology & Hepatology.
Roughly 100 Dutch patients who’d had an episode of left-sided diverticulitis followed by either ongoing abdominal complaints lasting at least 3 months or frequently recurring diverticulitis (at least three recurrences with clinical signs of diverticulitis within 2 years) were randomized to sigmoidectomy or conservative management. A quarter of the conservative management patients eventually underwent surgery because of ongoing symptoms.
At 6 months’ follow-up, health-related quality-of-life scores were 14 points better in the surgical than the conservative management group (a 10-point difference was considered clinically meaningful). Roughly 15% of the surgical patients had anastomotic leakage.
Given the risks, a commentator concludes: “In line with existing guidelines, elective sigmoid resection should be reserved for selected cases with frequent recurrences or severe abdominal complaints accompanied by morphological findings of chronic inflammation.”