Elective Surgery Tied to Better Quality of Life in Certain Patients with Diverticulitis

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.”