[Surgical therapy of diverticulitis]

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Increasing prevalence of sigmoid diverticular disease in industrialized nations.
• Surgical intervention is recommended for complicated or recurrent disease, and in younger patients after a severe first episode.

Purpose of the Study:

• To outline current practice parameters for surgical management of sigmoid diverticular disease.
• To discuss preferred surgical techniques, including elective sigmoid resection and laparoscopic approaches.

Main Methods:

• Review of practice parameters and surgical recommendations for sigmoid diverticular disease.
• Discussion of elective sigmoid resection with primary anastomosis as the preferred procedure.
• Consideration of two-stage surgery for emergency situations and laparoscopic techniques.

Main Results:

• Elective sigmoid resection with primary anastomosis is the preferred surgical approach.
• Two-stage surgery (resection without anastomosis, followed by restoration of continuity) is recommended for emergency cases.
• Laparoscopic surgery offers advantages but requires surgeon expertise and has a learning curve.

Conclusions:

• Surgical management of sigmoid diverticular disease should be tailored to disease severity and patient factors.
• Laparoscopic sigmoid resection is the preferred technique when feasible, prioritizing patient safety.
• Conversion to open surgery is a responsible decision when necessary for patient well-being.