A recent study published in JAMA Surgery suggests that elective surgery for diverticulitis can lead to quality of life benefits and fewer recurrences. Both elective sigmoid resection and conservative treatment are options for patients with recurrent, complicated, or persistent painful diverticulitis, and understanding the outcomes of each can help inform decision-making.
The study aimed to compare the outcomes of elective sigmoid resection and conservative treatment for patients with recurrent, complicated, or persistent painful diverticulitis at a 2-year follow-up. The study was a multicenter parallel open-label individually randomized clinical trial conducted in five Finnish hospitals between September 2014 and October 2018.
A total of 85 patients were included in the study, with 41 randomized to the surgery group and 44 to the conservative treatment group. After exclusions, these patients were included in the intention-to-treat analyses. Eight patients (18%) in the conservative treatment group eventually underwent sigmoid resection within 2 years.
The study found that the surgery group had a higher mean Gastrointestinal Quality of Life Index (GIQLI) score at 1 year compared to the conservative group, with a difference of 9.51 points. However, at the 2-year mark, the mean GIQLI scores were similar between the two groups. Within 2 years, 61% of the patients in the conservative group experienced recurrent diverticulitis, while only 11% of the surgery group did. Major postoperative complications were also lower in the conservative group, with 10% of the surgery group and 5% of the conservative group experiencing such complications within 2 years.
The results of the study suggest that elective sigmoid resection can effectively prevent recurrent diverticulitis and improve the quality of life compared to conservative treatment within 2 years. However, it is important to consider the potential risks and benefits of each treatment option before making a decision.