Elective Colectomy for Diverticulitis in Transplant Patients: Is It Worth the Risk?

The aim of this study was to determine morbidity and mortality for transplant patients undergoing elective colectomy for diverticulitis and determine the impact of recurrent diverticulitis on postoperative complications.

We identified transplant recipients that underwent elective colectomy for diverticulitis between 2000 and 2015 at a tertiary care institution. Patient and procedure variables, postoperative complications, length of stay, 30-day readmission, and mortality were identified through retrospective chart review. Complication rates were compared between patients with one previous episode of diverticulitis versus two or more.

Thirty transplant recipients underwent colectomy for primary (n = 13) or recurrent (n = 17) diverticulitis. Primary anastomosis was performed in 26 (87%) with proximal diversion in 10 (38%). The overall complication rate was 57%, with surgical site infection being the most common (23%). There were no anastomotic leaks at the colorectal anastomosis or reoperations. Median length of stay was 8 days (range 4-23). Postoperative complications were not significantly different between groups (54 vs. 59%, p = 0.94).

Postoperative morbidity after elective colectomy for diverticulitis in transplant recipients was common. There were no differences in complications for patients with primary versus recurrent diverticulitis. Fear of postoperative complications from recurrent diverticulitis should not be a reason to recommend elective colectomy after an initial attack of diverticulitis in transplant patients.