Title: My thoughts: The changing role of elective colectomy for diverticular disease
Abstract: Diverticulitis has traditionally been considered episodic in nature, and these discrete episodes have guided decisions regarding elective colectomy. The indications for elective colectomy in patients who have had diverticulitis have become increasingly conservative over time. Rather than offering surgery after two episodes of diverticulitis (or one episode in younger patients) societies began advocating for a more individualized approach. Initially, individualization focused on the number or frequency of episodes, and the primary goal was to prevent future diverticulitis occurrences. Early on, there was concern a more conservative approach may lead to more complicated disease. A study of the Nationwide Inpatient Sample in 2009 found that although the incidence of diverticular abscesses had increased, the rate of diverticular perforations remained unchanged. 1 Ricciardi R. Baxter N.N. Read T.E. Marcello P.W. Hall J. Roberts P.L. Is the decline in the surgical treatment for diverticulitis associated with an increase in complicated diverticulitis?. Dis Colon Rectum. 2009 Sep; 52: 1558-1563 Crossref PubMed Scopus (105) Google Scholar However, an under-recognized consequence of performing fewer elective colectomies is the increased development of chronic gastrointestinal symptoms. As a result, terms such as chronic diverticulitis, atypical diverticulitis, and symptomatic uncomplicated diverticular disease are now being described.
Publication Year: 2023
Publication Date: 2023-12-01
Language: en
Type: editorial
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 1
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