Clinical and Economic Insights Into Surgery for Colonic Diverticular Perforation: A Long-Term Observational Cohort...

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Clinical Epidemiology

Background:

• Colonic diverticular perforation is a serious condition with poorly understood clinical characteristics.
• Differentiating between right-sided and left-sided perforations may offer insights into disease severity and patient outcomes.

Purpose of the Study:

• To clarify the clinical characteristics of colonic diverticular perforation.
• To compare outcomes between right-sided and left-sided colonic diverticular perforations.

Main Methods:

• Retrospective evaluation of 138 patients who underwent surgery for colonic diverticular perforation between 2011 and 2021.
• Patients were categorized into right-sided (20) and left-sided (118) colon cohorts based on perforation location.

Main Results:

• The sigmoid colon was the most common site for perforation.
• Left-sided perforations were associated with older age, higher hemoglobin and albumin levels, longer intensive care unit (ICU) stays, higher complication rates, longer hospital stays, and increased hospitalization costs.
• Right-sided perforations showed lower blood urea nitrogen and creatinine levels.

Conclusions:

• Clinical characteristics and outcomes of colonic diverticular perforation significantly differ based on perforation location.
• Left-sided perforations present with worse patient conditions, prolonged hospital stays, and higher costs compared to right-sided perforations.
• Advanced age (≥75 years) may be linked to prolonged hospital stays and elevated costs in left-sided perforations.