Recurrent left-sided diverticulitis after surgery: A systematic review and single arm meta-analysis

Area of Science:

• Gastroenterology
• Surgical Oncology
• Epidemiology

Background:

• Recurrent diverticulitis post-resection is a significant clinical challenge.
• Potential causes include incomplete resection, synchronous disease, and altered colonic function.
• Minimally invasive surgical techniques aim to improve outcomes.

Purpose of the Study:

• To systematically review and meta-analyze long-term recurrence and stoma rates after elective surgery for left-sided diverticulitis.
• To assess the durability of surgical control in managing this condition.

Main Methods:

• Systematic review and single-arm meta-analysis following PRISMA guidelines.
• Searched PubMed, Cochrane, and Scopus databases (2000-2025).
• Utilized random-effects models for meta-analysis of proportions; assessed study quality using JBI Checklist.

Main Results:

• Included 24 studies with 7,525 patients; mean follow-up of 53 months.
• Pooled recurrence rate was 6.2% (95% CI: 4.8-8.0%), consistent across study types and disease severity.
• Pooled stoma rate was 17.1% (95% CI: 8.4-31.9%), significantly higher in complicated cases and lower in post-2020 studies.

Conclusions:

• Surgical resection provides durable control of left-sided diverticulitis with low recurrence rates.
• Stoma rates have significantly decreased in recent years, suggesting procedural improvements.
• Future research should focus on standardized recurrence definitions, quality of life assessment, and microbiome influences.