Members of GISDIC are co-authors of this study and can be found under the heading Collaborators.
Multicentre observational study of the natural history of left-sided acute diverticulitis†
Article first published online: 21 NOV 2011
Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
British Journal of Surgery
Volume 99, Issue 2, pages 276–285, February 2012
How to Cite
Binda, G. A., Arezzo, A., Serventi, A., Bonelli, L. and on behalf of the Italian Study Group on Complicated Diverticulosis (GISDIC) (2012), Multicentre observational study of the natural history of left-sided acute diverticulitis. Br J Surg, 99: 276–285. doi: 10.1002/bjs.7723
Presented in part to GASTRO 2009 (United European Gastroenterology Federation and World Gastroenterology Organization), London, UK, November 2009
- Issue published online: 6 JAN 2012
- Article first published online: 21 NOV 2011
- Manuscript Accepted: 23 AUG 2011
Vol. 99, Issue 4, 600, Article first published online: 7 MAR 2012
The natural history of acute diverticulitis (AD) is still unclear. This study investigated the recurrence rate, and the risks of emergency surgery, associated stoma and death following initial medical or surgical treatment of AD.
The Italian Study Group on Complicated Diverticulosis conducted a 4-year multicentre retrospective and prospective database analysis of patients admitted to hospital for medical or surgical treatment of AD and then followed for a minimum of 9 years. The persistence of symptoms, recurrent episodes of AD, new hospital admissions, medical or surgical treatment, and their outcome were recorded during follow-up.
Of 1046 patients enrolled at 17 centres, 743 were eligible for the study (407 recruited retrospectively and 336 prospectively); 242 patients (32·6 per cent) underwent emergency surgery at accrual. After a mean follow-up of 10·7 years, rates of recurrence (17·2 versus 5·8 per cent; P < 0·001) and emergency surgery (6·9 versus 1·3 per cent; P = 0·021) were higher for medically treated patients than for those treated surgically. Among patients who had initial medical treatment, age less than 40 years and a history of at least three episodes of AD were associated with an increased risk of AD recurrence. There was no association between any of the investigated parameters and subsequent emergency surgery. The risk of stoma formation was below 1 per cent and disease-related mortality was zero in this group. The disease-related mortality rate was 0·6 per cent among patients who had surgical treatment.
Long-term risks of recurrent AD or emergency surgery were limited and colectomy did not fully protect against recurrence. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.