Medical and Surgical Therapy in Diverticular Disease

Elective laparoscopic colonic resection for diverticular disease

“…Most of the patients remain asymptomatic but 10 to 20% will develop symptoms or complications, especially infection [12,16]. The surgical indications for elective diverticular disease are now well established.…”

“…Most surgeons, as in our study use a laparoscopically assisted technique: The technical details of the procedure have been previously described [5]. In a few cases, a small infraumbilical median or horizontal suprapubic incision can be done for removal of the specimen allowing a hand-sewn colorectal anastomosis [16,21]. In our series, this was done in 18 patients, either by design or because of severe sigmoid inflammation.…”

Elective laparoscopic-assisted colectomy for diverticular disease

“…It is found in approximately half of people aged over 60 years, but only a few develop symptoms or complications that require emergency surgery [29]. Until recently, many patients with documented acute diverticulitis who have recovered from an acute attack were managed medically, on the assumption that only a few will have a recurrent attack [20,27].…”

Practice Parameters for Sigmoid Diverticulitis

“…10,15,16,[28][29][30][31][32][33] Uncomplicated diverticulitis may be managed as an outpatient (dietary modification and oral antibiotics) for those without appreciable fever, excessive vomiting, or marked peritonitis, as long as there is the opportunity for follow-up. The patient should be able to take liquids and antibiotics by mouth.…”

“…Long-term fiber supplementation after recovery from a first episode of diverticulitis may prevent recurrence in >70 percent of patients followed for more than five years. 34,35 The likelihood of death from uncomplicated diverticulitis treated medically is low. 36 Immunosuppressed or immunocompromised patients with acute diverticulitis are more likely to present with perforation or fail medical management.…”