Surgical outcomes and their relation to the number of prior episodes of diverticulitis

Purpose:We aimed to investigate the relationship between the number of prior episodes of diverticulitis and outcomes of sigmoid colectomy.Methods:After institutional review board approval,a retrospective review was undertaken based on records of patients who underwent sigmoid resection with anastomosis for diverticulitis between 4 May 2007 and 29 February 2012.Patients were divided into two groups:0–3 attacks(group 1)and4 attacks(group 2).Statistical analyses were performed to determine whether the groups differed on demographic,intra-operative and postoperative variables.Results:We identified 247 patients who underwent sigmoid colectomy for diverticulitis(45 open,202 laparoscopic).The two groups did not differ significantly in age,gender,American Society of Anesthesiologists score,past surgical history,body mass index,length of stay,use of a stoma or number of prior hospitalizations for diverticulitis.Group 1 had a higher rate of abscesses(30.6 vs 6.8%,P<0.001)and fistulas(19.4 vs 0.9%,P<0.001);a longer operative time(190.1 vs 166.3 min,P=0.0024);and higher rates of postoperative complications(45.8 vs 23.3%,P<0.001)and conversion(17.1 vs 4.4%,P=0.0091).The most common surgical complications in groups 1 and 2 were wound infection(35 vs 10)and ileus(20 vs 8).Based on multivariate regression analysis,4 attacks were independently correlated with a lower complication rate(odds ratio=0.512,95%confidence interval=0.266–0.987,P=0.046).Conclusions:Patients who had4 previous attacks of diverticulitis had fewer postoperative complications.