Is prophylactic resection valid as an indication for elective surgery in diverticular disease?

To determine whether interval resection in asymptomatic patients after 1 or 2 episodes of acute diverticulitis (prophylactic resection) is justified as a means of preventing late inflammatory complications of diverticular disease.

A retrospective analysis.

A university-affiliated tertiary care hospital.

Those requiring hospitalization from 1987 to 1995 for treatment of acquired diverticular disease of the colon. Twenty-eight patients underwent elective resection and 154 were treated for inflammatory complications (perforation, fistula, complete large-bowel obstruction).

Standard surgical management for diverticular disease, but only 3 prophylactic resections were undertaken during this period.

Type of operation, stoma creation and closure, hospital death. In those treated for complicated disease, the effects on outcome of all previous outpatient treatment and hospitalizations.

Only 10% of those presenting with complications had been treated conservatively for acute diverticulitis and only 5% had been hospitalized for this reason.

Prophylactic resection is unlikely to prevent late major complications of diverticular disease; therefore, as an elective indication for surgery in this disease its use is questionable.