Elective vs. early elective surgery in diverticular disease: a retrospective study on the optimal timing of non-emergency treatment.

PURPOSE

This study set out to compare the in-hospital outcomes of early elective and elective laparoscopic sigmoidectomy due to diverticulitis.

METHODS

We examined the data for 378 diverticulitis patients who received an elective laparoscopic sigmoid resection between 2008 and 2012. We divided the patients into two groups: elective (group A, n = 278) and early elective (group B, n = 100). Patients in group A received surgery during the inflammation-free interval, and those in group B immediately after treating the attack with IV antibiotics for a mean period of 8 days (IQR = 3).

RESULTS

Overall mortality was 0%. The mean operation duration was the same in both groups being 77.5 and 80 min respectively. There was no significant difference in the outcomes between the two groups, measured using the Clavien-Dindo classification of surgical complication (CCSC; p = 0.992). A revision due to complications was necessary in 16 cases (group A) and six cases (group B) (p = 0.820). The conversion rate to open surgery was low (six individuals in group A, vs. four in group B; p = 0.331). Patients in group B suffered significantly fewer diverticulitis attacks (three in group A, vs. two in group B; p = 0.026).

CONCLUSION

Our study showed no difference in outcome between elective and early elective cases. Operation durations were optimal in both cases and were 50% shorter than those recorded in the literature. An early elective operation represents a good treatment option, especially for patients suffering from complicated diverticulitis.