Sigmoidectomy with primary anastomosis for complicated diverticulitis

Abstract

Background: It is possible to resect the perforated segment and reestablish intestinal continuity with adequate morbidity and mortality results in patients with complicated diverticulitis. Aims: To evaluate the type of surgery performed at our center and the results of the procedures in patients with complicated diverticulitis. Material and methods: All patients that underwent sigmoidectomy due to complicated diverticulitis within the time frame of 2005-2012 were included in the study. The primary objective was to evaluate the type of surgery performed. The secondary objective was to evaluate patient morbidity and mortality after 30 postoperative days. Results: The study included 77 patients with a mean age of 51.17 ± 12.80 years. The majority of the patients were men (64.9%) (n = 50) and the mean BMI was 28.24 ± 4.06 kg/m2. A total of 63.6% (n = 49) patients presented with a Hinchey iii-iv classification. Sigmoidectomy with primary anastomosis was performed in 58.4% (n = 45) of the patients, 48.8% (22/45) of whom presented with Hinchey iii-iv. Primary anastomosis was more frequently performed in patients that had Hinchey i-ii (P=.001). Open surgery was carried out in 85.7% (n = 66) of the cases. The mean surgery duration was longer in the patients with primary anastomosis (181.73 ± 68.2 min vs. 152.13 ± 65.8 min) (P>.05). Colorectal surgeons performed the procedures in 44.2% (n = 34) of the cases. Complications presented in 23.4% (n = 18) of the patients and there was a tendency toward more complications in patients that underwent the Hartmann's procedure. The mortality rate was 2.6% (n = 2). Conclusions: Sigmoidectomy with primary anastomosis is a frequent surgery in patients with complicated diverticulitis at our hospital. There was no difference in morbidity and mortality, compared with the Hartmann's procedure.

Keywords

• Complicated diverticulitis
• Primary anastomosis
• Hartmann's procedure