[Sigmoid diverticulitis. Extent of resection and choice of procedure]

Diverticular disease of the colon ranks in prevalence equal to diabetes or coronary heart disease. Surgical treatment of colonic diverticulitis is in general very successful. Therapeutic options have broadened in recent years: while improved diagnostic modalities allow a pre-surgical containment of the disease process by percutaneous techniques, minimally-invasive surgical procedures can replace conventional surgery in many cases without a change in the risk of complications. However, there is no proof of a general superiority of the laparoscopic approach. Surgical morbidity and mortality mainly derives from perforations with diffuse peritonitis. As a rule, these cases should be treated by a Hartmann procedure. In selected cases it is also possible to perform a primary anastomosis. This decision should be guided by well-known scoring systems.