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Surgery for Sigmoid Diverticular Disease—How the East Differs from the West?

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Abstract

Diverticular disease is a major healthcare problem in the West and recent studies indicate an increase in its incidence in India. Data on surgical management of diverticulitis in India is sparse. This study aims to report our experience of the surgical management of sigmoid diverticular disease over a 7-year duration. This study reports a case series analysis of data obtained from a database of patients undergoing surgery for colorectal diseases at a tertiary care setup in India. Patients who were operated on between January 2016 and January 2023 for sigmoid diverticular disease were selected for this study. A total of 102 patients were operated on for sigmoid diverticular disease with 81 patients (79.4%) being operated on electively and 21 (20.6%) emergency surgeries. The most common indication for surgery in elective setting was complicated diverticulitis with colovesical/colovaginal fistula, and in emergency setting, intestinal obstruction was the most common indication. In the Indian scenario, surgery for colovesical/colovaginal fistulae is a more common indication than recurrent acute diverticulitis.

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References

  1. Painter NS, Burkitt DP (1971) Diverticular disease of the colon: a deficiency disease of Western civilization. Br Med J 2:450–454. https://doi.org/10.1136/bmj.2.5759.450

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  2. Balsara KP, Dastoor K, Subash C et al (2020) Surgery for sigmoid diverticulitis. “An eighteen-year experience.” Trop Gastroenterol 41:16–21. https://doi.org/10.7869/tg.567

    Article  Google Scholar 

  3. Goenka MK, Nagi B, Kochhar R et al (1994) Colonic diverticulosis in India: the changing scene. Indian J Gastroenterol 13:86–88

    PubMed  CAS  Google Scholar 

  4. Hall J, Hardiman K, Lee S et al (2020) The American Society of Colon and Rectal Surgeons clinical practice guidelines for the treatment of left-sided colonic diverticulitis. Dis Colon Rectum 63:728–747. https://doi.org/10.1097/DCR.0000000000001679

    Article  PubMed  Google Scholar 

  5. Lumpkin ST, Chaumont N (2019) Management of freely perforated diverticulitis. Dis Colon Rectum 62:1153–1156. https://doi.org/10.1097/DCR.0000000000001457

    Article  PubMed  PubMed Central  Google Scholar 

  6. Singh A, Kapoor D, Dubey S et al (2022) Short-term outcomes following hand-assisted laparoscopy for left-sided colon and rectal malignancies: single-center experience of 580 cases. Indian J Surg 84:326–334. https://doi.org/10.1007/s12262-021-02868-1

    Article  Google Scholar 

  7. Linzay CD, Pandit S. (2023) Acute Diverticulitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459316/

  8. DeLeon MF, Sapci I, Akeel NY et al (2019) Diverticular colovaginal fistulas: what factors contribute to successful surgical management? Dis Colon Rectum 62:1079–1084. https://doi.org/10.1097/DCR.0000000000001445

    Article  PubMed  Google Scholar 

  9. Berríos-Torres SI, Umscheid CA, Bratzler DW et al (2017) Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 152:784–791. https://doi.org/10.1001/jamasurg.2017.0904

    Article  PubMed  Google Scholar 

  10. Ellis CT, Maykel JA (2021) Defining anastomotic leak and the clinical relevance of leaks. Clin Colon Rectal Surg 34:359–365. https://doi.org/10.1055/s-0041-1735265

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bragg D, El-Sharkawy AM, Psaltis E et al (2015) Postoperative ileus: recent developments in pathophysiology and management. Clin Nutr Edinb Scotl 34:367–376. https://doi.org/10.1016/j.clnu.2015.01.016

    Article  Google Scholar 

  12. Anaya DA, Flum DR (2005) Risk of emergency colectomy and colostomy in patients with diverticular disease. Arch Surg Chic Ill 1960 140:681–68. https://doi.org/10.1001/archsurg.140.7.681

    Article  Google Scholar 

  13. Klarenbeek BR, Samuels M, van der Wal MA et al (2010) Indications for elective sigmoid resection in diverticular disease. Ann Surg 251:670–674. https://doi.org/10.1097/SLA.0b013e3181d3447d

    Article  PubMed  Google Scholar 

  14. Miccini M, Borghese O, Scarpini M et al (2011) Urgent surgery for sigmoid diverticulitis. Retrospective study of 118 patients. Ann Ital Chir 82:41–48

    PubMed  Google Scholar 

  15. Haas JM, Singh M, Vakil N (2016) Mortality and complications following surgery for diverticulitis: systematic review and meta-analysis. United Eur Gastroenterol J 4:706–713. https://doi.org/10.1177/2050640615617357

    Article  Google Scholar 

  16. Faes S, Hübner M, Demartines N et al (2021) Elective surgery for diverticulitis in Swiss hospitals. Front Surg 8:717228. https://doi.org/10.3389/fsurg.2021.717228

    Article  PubMed  PubMed Central  Google Scholar 

  17. Mizrahi I, Abu-Gazala M, Fernandez LM et al (2021) Elective minimally invasive surgery for sigmoid diverticulitis: operative outcomes of patients with complicated versus uncomplicated disease. Colorectal Dis 23:2948–2954. https://doi.org/10.1111/codi.15837

    Article  PubMed  Google Scholar 

  18. Kakodkar R, Gupta S, Nundy S (2005) Complicated colonic diverticulosis: surgical perspective from an Indian Centre. Trop Gastroenterol: Off J Dig Dis Found 26(3):152–155

    Google Scholar 

  19. Smeenk RM, Plaisier PW, van der Hoeven JAB, Hesp WLEM (2012) Outcome of surgery for colovesical and colovaginal fistulas of diverticular origin in 40 patients. J Gastrointest Surg Off J Soc Surg Aliment Tract 16:1559–1565. https://doi.org/10.1007/s11605-012-1919-1

    Article  CAS  Google Scholar 

  20. Gervaz P, Mugnier-Konrad B, Morel P et al (2011) Laparoscopic versus open sigmoid resection for diverticulitis: long-term results of a prospective, randomized trial. Surg Endosc 25:3373–3378. https://doi.org/10.1007/s00464-011-1728-8

    Article  PubMed  Google Scholar 

  21. Raue W, Paolucci V, Asperger W et al (2011) Laparoscopic sigmoid resection for diverticular disease has no advantages over open approach: midterm results of a randomized controlled trial. Langenbecks Arch Surg 396:973–980. https://doi.org/10.1007/s00423-011-0825-4

    Article  PubMed  Google Scholar 

  22. Hanna MH, Kaiser AM (2021) Update on the management of sigmoid diverticulitis. World J Gastroenterol 27:760–781. https://doi.org/10.3748/wjg.v27.i9.760

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Lee SW, Yoo J, Dujovny N et al (2006) Laparoscopic vs. hand-assisted laparoscopic sigmoidectomy for diverticulitis. Dis Colon Rectum 49:464–469. https://doi.org/10.1007/s10350-006-0500-y

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of GI Surgery, GI Oncology and Bariatric Surgery, Medanta the Medicity, Gurugram, India

    Amanjeet Singh, Archit Gupta, Deeksha Kapoor, Azhar Perwaiz & Adarsh Chaudhary

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  1. Amanjeet Singh
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  2. Archit Gupta
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  3. Deeksha Kapoor
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  4. Azhar Perwaiz
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  5. Adarsh Chaudhary
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Correspondence to Archit Gupta.

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Singh, A., Gupta, A., Kapoor, D. et al. Surgery for Sigmoid Diverticular Disease—How the East Differs from the West?. Indian J Surg (2024). https://doi.org/10.1007/s12262-023-04015-4

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