IS PROPHYLACTIC RESECTION VALID AS AN INDICATION FOR ELECTIVE SURGERYIN DIVERTICULAR-DISEASE

OBJECTIVE: To determine whether interval resection in asymptomatic pat ients after 1 or 2 episodes of acute diverticulitis (prophylactic rese ction) is justified as a means of preventing late inflammatory complic ations of diverticular disease. DESIGN: A retrospective analysis. SETT ING: A university-affiliated tertiary care hospital. PATIENTS: Those r equiring hospitalization from 1987 to 1995 for treatment of acquired d iverticular disease of the colon. Twenty-eight patients underwent elec tive resection and 154 were treated for inflammatory complications (pe rforation, fistula, complete large-bowel obstruction). INTERVENTIONS: Standard surgical management for diverticular disease, but only 3 prop hylactic resections were undertaken during this period. OUTCOME MEASUR ES: Type of operation, stoma creation and closure, hospital death. In those treated for complicated disease, the effects on outcome of all p revious outpatient treatment and hospitalizations. RESULTS: Only 10% o f those presenting with complications had been treated conservatively for acute diverticulitis and only 5% had been hospitalized for this re ason. CONCLUSIONS: Prophylactic resection is unlikely to prevent late major complications of diverticular disease; therefore, as an elective indication for surgery in this disease its use is questionable.