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Related Experiment Video

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Standardizing Elective Surgery in Diverticular Disease.

Giulio Mari1, Richard Sassun1, Stefano Maria De Carli1

  • 1Laparoscopic and Oncological General Surgery Department, Desio Hospital, ASST Brianza, 20832 Desio, Italy.

Annali Italiani Di Chirurgia
|October 16, 2025
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Summary
This summary is machine-generated.

A standardized laparoscopic sigmoidectomy for diverticular disease (DD) is safe and effective, significantly improving quality of life. This approach offers lasting relief with low complication and recurrence rates for patients with recurrent or complicated DD.

Keywords:
GIQLISUDDdiverticular diseasesigmoidectomy

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Diverticular disease (DD) is a common gastrointestinal condition with varied presentations, from uncomplicated symptoms to acute complications requiring surgery.
  • Elective sigmoidectomy is a key treatment for Complicated Diverticular Disease (CDD), Symptomatic Uncomplicated Diverticular Disease (SUDD), and Recurrent Diverticulitis (RD).

Purpose of the Study:

  • To evaluate the short- and long-term outcomes of a standardized surgical approach for diverticular disease.
  • To assess the safety, efficacy, and quality of life improvements following elective sigmoidectomy for DD.

Main Methods:

  • Retrospective analysis of 442 patients undergoing elective sigmoidectomy or left hemicolectomy for DD (2012-2020).
  • Standardized laparoscopic surgical protocol including medial to lateral approach, artery preservation, specific resection level, and anastomosis with ICG testing.
  • Inclusion of SUDD, RD, and CDD patient groups with a mean follow-up of 5 years; assessment of intraoperative details, complications, recurrence, and GIQLI scores.

Main Results:

  • The standardized procedure had a mean operative time of 121 minutes, 5.2% conversion rate, and 16.1% overall complication rate, with 4.9% major complications (anastomotic leaks).
  • Diverticulitis recurrence was 5.2%, significantly associated with disease duration >5 years (HR 2.42, p=0.028).
  • GastroIntestinal Quality of Life Index (GIQLI) scores significantly improved at 1 year (p<0.001) and 5 years (p<0.001) post-surgery.

Conclusions:

  • Standardized laparoscopic sigmoidectomy for DD is a safe and effective procedure with low complication and recurrence rates.
  • The surgery leads to significant and lasting improvements in patient quality of life, particularly for those with recurrent or complicated disease.
  • Standardization of surgical techniques is crucial for optimizing safety and efficacy in managing diverticular disease.