Time Trends in Emergency Sigmoidectomy for perforated Diverticulitis: A Single-Center Evaluation
Juul Meurs, David Zimmerman, Daria K. Wasowicz, Tina van Loon, Barbara LangenhoffAbstract
Background:
Optimal surgical treatment for complicated sigmoid diverticulitis remains a subject of considerable debate, especially in the era of laparoscopy.
Objectives:
This study evaluated changes over time in emergency sigmoidectomy for perforated diverticulitis, including the period following the implementation of laparoscopy in a large community teaching hospital.
Design:
Retrospective chart review.
Setting:
Single-center study.
Patients and Methods:
All patients who underwent emergency sigmoidectomy for perforated sigmoid diverticulitis between 2007 and 2018 were retrospectively analyzed.
Main Outcome Measure:
Postoperative morbidity and mortality.
Sample Size:
A total of 104 patients (male: female, 58:46; median age, 62.7 years; median body mass index, 27.15 kg/m²) underwent emergency sigmoidectomy.
Results:
The overall mortality rate was 5%, the complication rate was 66%, and the median length of stay was 11 days. A significant increase in laparoscopic sigmoidectomy procedures was observed, resulting in 94.3% intended laparoscopic procedures from 2015 onward, compared with 0% in 2007–2010 and 50.0% in 2011–2014 (
Conclusion:
Laparoscopic sigmoidectomy has become our primary surgical treatment for patients with perforated sigmoid diverticulitis requiring operative intervention. This study demonstrates a significant reduction in morbidity and length of stay over time, with a clear benefit of laparoscopic surgery compared with open surgery.
Limitations:
The retrospective observational character of the study. Single-center study.
Conflicts of interest:
There are no conflicts of interest.