Health Related Quality of Life and Clinical Outcome After Colonic Resection for Diverticular Disease: Long-Term Results
Marco Scarpa, Duilio Pagano, Cesare Ruffolo, Anna Pozza, Francesa Erroi, Lino Polese, Davide F. D'Amico, Imerio Angriman*
Clinica Chirurgica 1^, University of Padova, Padova, Italy
Background and Aims: Colonic resection is mandatory in complicated colonic diverticular disease (DD). The most appropriate treatment in case of recurrent diverticulitis episodes, is less clear. The aim of the present study was to evaluate the long term clinical outcome and quality of life in patients affected by DD submitted to colonic resection compared to those who had only medical treatment.
Patients and Methods: Seventy-one consecutive patients admitted in our department for left iliac pain and endoscopical or radiological diagnosis of diverticular disease were enrolled. During the hospital stay 25 of them underwent colonic resection while 46 were treated with medical therapy. Diseased severity was assessed with Hinchey scale. After a median follow up of 47 (3-102) months after colonic resection, they were interviewed and they answered to Cleveland Global Quality of Life (CGQL) questionnaire and to a symptoms questionnaire. Admittance and surgical procedures for DD were also investigated and surgery- and symptoms-free were calculated. Non parametric tests and survival analysis was used.
Results: After the follow up, CGQL total score obtained by the two patients were similar as well as the symptoms frequency. Only current quality of health item was significantly worse in patients who had undergone colonic resection (p=0.05). No difference was evidenced in the rate and in the timing of surgical procedures and hospital admitting for DD in the two groups. In particular the 9 patients who had been operated on for an Hinchey 1 class diverticulitis reported the same quality of life, symptoms frequency, operation and hospital admitting rate than those who had been admitted for an Hinchey 1 class diverticulitis and treated conservatively.
Conclusions: Our study did not show any long term advantage in submitting patients to colonic resection for DD. Thus, in our opinion, surgical resection should be reserved to patients who present with a complicated DD and not to patients who present a mere abdominal discomfort attributed to DD.
