[Elective laparoscopic colectomy in uncomplicated diverticulitis: when should surgery be performed]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Context:

• Surgical resection for acute diverticulitis is indicated after multiple episodes or with complications.
• The optimal timing for elective surgery after acute diverticulitis remains debated.
• Laparoscopic colectomy offers advantages over open surgery but conversion rates impact morbidity.

Purpose:

• To evaluate the impact of the time interval to surgery on outcomes after laparoscopic left colectomy (LCR) for NCD.
• To compare operative incidents, postoperative complications, and pathological findings between early (<90 days) and delayed (>90 days) surgery.

Summary:

• A retrospective analysis compared 39 patients undergoing LCR within 90 days (Group A) versus 38 patients beyond 90 days (Group B) after the last NCD episode.
• Group B showed significantly lower overall abdominal morbidity (5% vs 21%) and residual inflammation (11% vs 31%) compared to Group A.
• While conversion rates were similar, delayed surgery was associated with shorter hospital stays (5.0 vs 7.7 days).

Impact:

• Performing laparoscopic left colectomy for acute diverticulitis beyond 90 days significantly reduces postoperative morbidity and residual inflammation.
• This timing optimizes surgical outcomes and patient recovery following elective resection for NCD.
• Findings support a delayed surgical approach to improve patient management in acute diverticulitis.