Effect of Elective Sigmoidectomy for Diverticulitis on Bowel Function Patient-Reported Outcomes

J Surg Res. 2019 Sep:241:135-140. doi: 10.1016/j.jss.2019.03.041. Epub 2019 Apr 22.

Abstract

Introduction: Diverticular disease is common worldwide. A subset of these patients will choose to undergo elective surgical resection because of symptoms or complicated disease. The aim of this study was to evaluate changes in bowel function after elective sigmoid resection for diverticular disease.

Materials and methods: We retrospectively reviewed patients seen at our institution from May 2015 to July 2018 who underwent elective sigmoid resection for diverticular disease. We used the Colorectal Functional Outcome (COREFO) questionnaire, a validated questionnaire that assesses bowel function in five domains and a global function score (scores 0-100, with higher score indicating worse function). We obtained questionnaire data at baseline, as well as at postoperative follow-up, and a paired t-test was used to compare.

Results: Forty-nine patients met criteria for inclusion in this study. The median time between questionnaire completion was 70 days (interquartile range: 56 to 85). The mean age was 60 ± 12 years, with 57% female patients. Thirty-six (73%) patients underwent sigmoidectomy alone and 13 (27%) underwent sigmoidectomy with fistula repair. Six patients (12%) had a diverting loop ileostomy in addition to sigmoidectomy and underwent a subsequent reversal. Overall, there were no differences in any of the five domains or the total Colorectal Functional Outcome score from baseline to postintervention.

Conclusions: In our cohort, bowel function did not significantly change in the early postoperative period after elective sigmoid resection for diverticular disease. Surgeons should counsel patients, especially symptomatic ones, that bowel function will likely be no different at time of postoperative follow-up.

Keywords: Diverticulitis; Elective sigmoid resection; Surgical outcomes.

MeSH terms

  • Aged
  • Colectomy / adverse effects
  • Colectomy / methods*
  • Colon, Sigmoid / physiopathology
  • Colon, Sigmoid / surgery
  • Diverticulitis, Colonic / physiopathology
  • Diverticulitis, Colonic / surgery*
  • Elective Surgical Procedures / adverse effects
  • Elective Surgical Procedures / methods*
  • Female
  • Humans
  • Ileostomy / adverse effects
  • Ileostomy / methods*
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Patient Satisfaction / statistics & numerical data
  • Postoperative Period
  • Retrospective Studies
  • Sigmoid Diseases / surgery*
  • Treatment Outcome