[Sigmoid diverticular diseases: surgical treatment]

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Surgical Outcomes

Background:

• Diverticular disease of the sigmoid colon frequently requires surgical intervention.
• Indications for surgery include complications like fistulas, abscesses, recurrent acute inflammation, chronic symptoms, and suspicion of carcinoma.
• Abscesses are common findings during surgery for diverticular disease.

Purpose of the Study:

• To evaluate the long-term outcomes of elective surgical treatment for sigmoid colon diverticular disease.
• To assess the efficacy of colonic resection with primary anastomosis versus the Hartmann procedure.
• To determine the optimal indications for elective surgery in diverticular disease.

Main Methods:

• A retrospective analysis of 226 consecutive patients undergoing elective sigmoid colon resection for diverticular disease between 1966 and 1990.
• Surgical procedures included colonic resection with primary anastomosis or the Hartmann procedure.
• Long-term follow-up (2-22 years) was conducted for patients operated on before 1987.

Main Results:

• No postoperative deaths or clinical anastomotic leakages were reported.
• 85% of patients experienced symptom resolution, 11% had persistent symptoms, and 3% reported recurrent attacks.
• Surgery for intra-mural or mesenteric abscesses was easier than for extracolic abscesses.
• 82% of patients operated on for chronic symptoms achieved good results, supporting their inclusion as surgical indications.

Conclusions:

• Elective surgical treatment for sigmoid colon diverticular disease yields favorable long-term results.
• Sigmoid colectomy with primary anastomosis is a safe and effective procedure.
• Chronic symptoms should be considered a valid indication for elective surgery in diverticular disease.
• Limited sigmoid resection is effective even in the presence of diffuse diverticula, with a low recurrence rate.