Trends in the Management of Non-emergent Surgery for Diverticular Disease and the Impact of Practice Parameters

Am Surg. 2023 Nov;89(11):4590-4597. doi: 10.1177/00031348221124319. Epub 2022 Aug 31.

Abstract

Background: Due to the rise in diverticular disease, the ASCRS developed practice parameters to ensure high-quality patient care. Our study aims to evaluate the impact of the 2014 practice parameters on the treatment of non-emergent left-sided diverticular disease.

Methods: This is a retrospective cohort study using the ACS-National Surgical Quality Improvement Project (ACS-NSQIP). Elective sigmoid resections performed by year were evaluated and compared before and after practice parameters were published.

Results: Overall, 46,950 patients met inclusion criteria. There was a significant decrease in the number of non-emergent operations when evaluating before and after guideline implementation (P < .001). There was a significant decrease in the number of patients younger than 50 years of age operated electively for diverticular disease (25.8% vs. 23.9%, P = .005). Adoption of minimally invasive surgery continued to increase significantly throughout the study period.

Conclusions: Publication of the 2014 ASCRS practice parameters is associated with a change in management of diverticular disease in the non-emergent setting.

Keywords: diverticular disease; diverticulitis; elective surgery; practice parameters.

Publication types

  • Practice Guideline

MeSH terms

  • Colectomy
  • Colon, Sigmoid / surgery
  • Diverticular Diseases* / complications
  • Diverticular Diseases* / surgery
  • Diverticulitis, Colonic* / complications
  • Diverticulitis, Colonic* / surgery
  • Elective Surgical Procedures
  • Humans
  • Retrospective Studies