Audit on complicated diverticular disease

Area of Science:

• Gastroenterology
• Surgical Oncology

Background:

• Complicated diverticular disease poses significant management challenges.
• Previous studies highlight varied mortality and morbidity rates associated with surgical interventions.

Purpose of the Study:

• To evaluate the outcomes of a conservative surgical policy for complicated diverticular disease.
• To assess hospital mortality and complication rates in patients treated between 1970 and 1983.

Main Methods:

• Retrospective review of 73 patients with complicated diverticular disease.
• Analysis of surgical approaches, including primary resection and conservative management.
• Documentation of hospital deaths, causes of death, and postoperative complications.

Main Results:

• Overall hospital mortality was 8% (6 deaths), with most deaths attributed to cardiorespiratory disease rather than sepsis.
• Complication rates were high: wound sepsis (29%), fistula after colostomy closure (12%), and anastomotic dehiscence (12%).
• Steroid therapy was associated with increased early mortality.

Conclusions:

• A conservative surgical strategy for complicated diverticular disease can achieve low hospital mortality.
• High complication rates necessitate careful patient selection and postoperative care.
• Prospective audits are crucial for refining management strategies.