Distal mucus fistula following resection for perforated sigmoid diverticular disease

A retrospective study of 62 consecutive patients undergoing resection of perforated diverticular disease was undertaken to assess influence of distal stump closure (DSC) or creating a distal mucus fistula (DMF) on subsequent restoration of bowel continuity. Forty-one patients underwent DSC and 21 DMF. Mean operating time and hospital stay were 164 min and 30 days for patients undergoing DSC compared with 142 min and 18 days for those undergoing DMF. Of the 54 survivors, 44 underwent reversal (25/35; DSC, 19/19; DMF). Mean operative time and hospital stay was 208 min and 17 days for DSC compared to 143 min and 10 days for DMF (P = 0.0003). Overall mortality and morbidity of either groups were comparable. Distal mucus fistula can often be safely created following resection of perforated sigmoid diverticulitis. This may result in higher reversal rates and significantly reduces the operating time and hospital stay without compromising the outcome.