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Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice

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Long-term survival after perforated diverticulitis.

J Vermeulen¹, M P Gosselink, W C J Hop

¹Erasmus Medical Center, Department of Surgery Rotterdam, The Netherlands. j.vermeulen.1@erasmusmc.nl

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland

|November 10, 2009

Summary

Long-term survival after emergency surgery for perforated diverticulitis is poor, with a 5-year survival rate of 53%. Patient

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Area of Science:

Gastroenterology
Surgical Oncology
Epidemiology

Background:

Short-term survival following emergency surgery for perforated diverticulitis is suboptimal.
Limited data exists on the long-term prognosis for these patients post-discharge.

Purpose of the Study:

To assess the long-term survival rates of patients after emergency surgery for perforated diverticulitis.
To identify prognostic factors influencing long-term survival in this patient cohort.

Main Methods:

A retrospective study included 340 patients undergoing emergency surgery for perforated diverticulitis (1990-2005).
Multivariate Cox regression analyzed the association between surgical type (Hartmann's vs. primary anastomosis) and survival, adjusting for age, ASA classification, Hinchey score, MPI, and surgeon experience.
Patient survival was compared to the matched general Dutch population.

Main Results:

Overall 5-year survival was 53%, significantly lower than the general population.
Long-term survival was independently associated with patient age and American Society of Anesthesiology (ASA) classification.
Hinchey score, Mannheim Peritonitis Index (MPI), re-interventions, surgeon experience, and surgical procedure type did not significantly impact long-term survival, though Hartmann's procedure showed a trend toward poorer outcomes.

Conclusions:

Long-term survival after perforated diverticulitis surgery is limited.
Patient's overall health status, not disease severity or surgical approach, is the primary determinant of long-term prognosis.