After Elective Sigmoid Colectomy for Diverticulitis, Does Recurrence-Free Mean Symptom-Free?

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Outcomes

Background:

• Diverticulitis is a common condition requiring surgical intervention.
• Elective sigmoidectomy aims to resolve diverticulitis symptoms but can lead to persistent abdominal symptoms (PSs).
• Understanding PSs and their risk factors is crucial for patient management post-sigmoidectomy.

Purpose of the Study:

• To determine the incidence and characteristics of persistent abdominal symptoms (PSs) after elective sigmoidectomy for diverticulitis.
• To identify independent risk factors associated with PSs in patients without diverticulitis recurrence.
• To analyze the impact of follow-up duration on PS prevalence.

Main Methods:

• Retrospective review of medical records for patients undergoing elective sigmoidectomy for diverticulitis (2002-2016).
• Post-operative questionnaires assessing diverticulitis recurrence and persistent abdominal symptoms.
• Statistical analysis to identify prevalence and risk factors for PSs.

Main Results:

• Of 346 patients without recurrence, 43.9% reported persistent abdominal symptoms.
• Female gender (RR 1.65) and preoperative irritable bowel syndrome (RR 1.41) were independent risk factors for PSs.
• Increased follow-up interval correlated with decreased PS prevalence (P = 0.006).

Conclusions:

• Persistent abdominal symptoms are common after sigmoidectomy for diverticulitis, affecting nearly half of patients.
• Female sex and a history of irritable bowel syndrome significantly increase the risk of developing PSs.
• Symptom prevalence decreases over time, suggesting potential for long-term improvement.