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[Surgical Indications for Diverticulitis in Germany: Are All Operations Justified?]
C W Schildberg1, V Schellerer1, R Croner1
1Chirurgie, Universität Erlangen, Deutschland.
Zentralblatt Fur Chirurgie
|August 3, 2013
Summary
Surgical treatment for sigma diverticulitis is increasing, but many operated patients have uncomplicated cases, suggesting potential over-treatment. Surgery is often necessary for complicated diverticulitis, but its justification for milder forms requires re-evaluation.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Health Services Research
Background:
- Sigma diverticulitis treatment is a significant part of emergency care, with a rising number of patients.
- The proportion of complicated versus non-complicated surgical cases requires clarification to assess treatment justification.
- Over-treatment in sigma diverticulitis surgery is a growing concern.
Purpose of the Study:
- To analyze the proportion of complicated and non-complicated surgical cases in sigma diverticulitis.
- To evaluate the justification of surgical interventions for sigma diverticulitis, particularly in milder forms.
- To assess trends in surgical treatment for sigma diverticulitis in Germany.
Main Methods:
- Prospective data collection from German hospitals using Diagnosis Related Groups (DRG) from 2005-2010.
- Retrospective analysis of Erlangen treatment data.
- Examination of treatment options based on the Hansen/Stock classification.
Main Results:
- Approximately 40% of stationary sigma diverticulitis patients in Germany undergo surgery.
- Two-thirds of operated patients present with uncomplicated diverticulitis.
- Complicated forms (perforations) are surgically treated, while the indication for surgery in milder forms is debated.
Conclusions:
- A significant rise in hospital admissions and surgical treatments for sigma diverticulitis is observed.
- The high rate of surgery for non-complicated cases indicates potential over-treatment.
- Surgery is often unavoidable for complicated diverticulitis, but its necessity for uncomplicated cases warrants critical review.
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