Surgical Intervention for Right-Side Diverticulitis: A Case-Matched Comparison with Left-Side Diverticulitis.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Epidemiology

Background:

• Right-side diverticulitis (RSD) is an uncommon condition in Western populations, often presenting differently than the more common left-side diverticulitis (LSD).
• Understanding the surgical management and outcomes of RSD is crucial for optimizing patient care, especially given its rarity.

Purpose of the Study:

• To compare the surgical management and outcomes of right-side diverticulitis (RSD) versus left-side diverticulitis (LSD).
• To identify demographic and clinical differences between patients with RSD and LSD requiring emergent surgery.

Main Methods:

• A case-matched comparison of 33 surgically managed RSD patients with 33 LSD patients from 2007-2014.
• Matching was based on age, gender, year of diagnosis, and Hinchey classification.
• Data analyzed included patient demographics, surgical procedures, hospital stay, and postoperative complications.

Main Results:

• RSD patients were more likely to be Asian and have a lower body mass index (<25) compared to LSD patients.
• Surgically managed RSD was associated with a significantly lower rate of diverting stoma (6.3% vs. 62.5%) and a shorter hospital stay (7.6 vs. 12.8 days).
• While open surgery and postoperative complications were more frequent in the LSD group, these differences were not statistically significant.

Conclusions:

• Surgery for complicated right-side diverticulitis is associated with a shorter hospital stay and a decreased likelihood of requiring a diverting ostomy compared to left-side diverticulitis.
• These findings suggest distinct clinical behaviors and potentially different surgical approaches may be beneficial for RSD.