Are there differences in outcome after elective sigmoidectomy for diverticular disease and for cancer? A national inpatient study
- PMID: 27422847
- DOI: 10.1111/codi.13461
Are there differences in outcome after elective sigmoidectomy for diverticular disease and for cancer? A national inpatient study
Abstract
Aim: The postoperative outcome after elective sigmoidectomy for diverticulitis has not been compared to that for cancer. The study aimed to evaluate the differences in the postoperative outcome after sigmoidectomy for diverticular disease and cancer.
Method: The National Inpatient Sample Database was used to identify patients who underwent elective sigmoid resection for diverticular disease or cancer between 2004 and 2011. After excluding patients with metastatic cancer and preoperative weight loss, sigmoid cancer and diverticulitis patients were matched using propensity score, controlling for age, gender, race, type of operation (open vs laparoscopic) and comorbidities. The end-points of interest were infective complications, reoperation, anastomotic leakage, rebleeding, length of hospital stay and in-hospital mortality.
Results: After propensity score matching (diverticulitis 11 192 patients, sigmoid cancer 11 192 patients), the mean age was 65 ± 12.5 years, 53.8% were male and 61.5% were Caucasian. Only 18.0% of the operations were done by laparoscopy. The overall complication rate was 17.7% and the in-hospital mortality rate was 0.9%. The diverticulitis group had a higher rate of surgical site infection (3.2% vs 2.6%, P = 0.004), intra-abdominal abscess formation (1.2% vs 0.4%, P < 0.0001) and reoperation (6.1% vs 4.1%, P < 0.0001) compared with the cancer group. The cancer group had a higher incidence of pneumonia (1.9% vs 1.5%, P = 0.01) and anastomotic leakage (9.2% vs 8.3%, P = 0.001). There was no difference in sepsis, deep vein thrombosis, respiratory failure, renal failure, rebleeding, overall complication rate or length of hospital stay. Subgroup analysis showed a higher in-hospital mortality for cancer than for diverticulitis patients whether resected by open or by laparoscopic surgery.
Conclusion: Although elective sigmoidectomy for diverticular disease has a higher risk of infective complications, elective sigmoidectomy for cancer has a higher risk of anastomotic leakage.
Keywords: Sigmoidectomy; colon cancer; colorectal surgery; diverticulitis; outcomes.
Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.
Similar articles
-
Laparoscopic sigmoidectomy in moderate and severe diverticulitis: analysis of short-term outcomes in a continuous series of 121 patients.Surg Endosc. 2013 May;27(5):1766-71. doi: 10.1007/s00464-012-2676-7. Epub 2013 Feb 23. Surg Endosc. 2013. PMID: 23436080
-
Laparoscopic colectomy for diverticulitis is not associated with increased morbidity when compared with non-diverticular disease.Int J Colorectal Dis. 2005 Mar;20(2):165-72. doi: 10.1007/s00384-004-0649-6. Epub 2004 Sep 30. Int J Colorectal Dis. 2005. PMID: 15459774
-
Laparoscopic sigmoid colectomy for complicated diverticulitis is safe: review of 576 consecutive colectomies.Surg Endosc. 2016 Apr;30(4):1629-34. doi: 10.1007/s00464-015-4393-5. Epub 2015 Aug 15. Surg Endosc. 2016. PMID: 26275534
-
Functional results following elective laparoscopic sigmoidectomy after CT-proven diagnosis of acute diverticulitis evaluation of 43 patients and review of the literature.J Gastrointest Surg. 2007 Jun;11(6):767-72. doi: 10.1007/s11605-007-0138-7. J Gastrointest Surg. 2007. PMID: 17417713 Review.
-
Surgical resection does not avoid the risk of diverticulitis recurrence-a systematic review of risk factors.Int J Colorectal Dis. 2021 Feb;36(2):227-237. doi: 10.1007/s00384-020-03762-0. Epub 2020 Sep 28. Int J Colorectal Dis. 2021. PMID: 32989503 Free PMC article.
Cited by
-
Cognition errors in the treatment course of patients with anastomotic failure after colorectal resection.Patient Saf Surg. 2019 Jan 23;13:4. doi: 10.1186/s13037-019-0184-6. eCollection 2019. Patient Saf Surg. 2019. PMID: 30679957 Free PMC article.
-
Nationwide volume-outcome relationship concerning in-hospital mortality and failure-to-rescue in surgery of sigmoid diverticulitis.Int J Colorectal Dis. 2023 Jul 31;38(1):203. doi: 10.1007/s00384-023-04495-6. Int J Colorectal Dis. 2023. PMID: 37522984
-
Comparison of Postoperative Outcome and Prognosis Among Laparoscopic Left Colectomy and Laparoscopic Sigmoidectomy in Sigmoid Colon Cancer Patients: A Propensity Score Matching Study.Cancer Control. 2023 Jan-Dec;30:10732748231210676. doi: 10.1177/10732748231210676. Cancer Control. 2023. PMID: 37982606 Free PMC article.
-
Low-pressure versus standard-pressure pneumoperitoneum in minimally invasive colorectal surgery: a systematic review, meta-analysis, and meta-regression analysis.Gastroenterol Rep (Oxf). 2024 Jul 19;12:goae052. doi: 10.1093/gastro/goae052. eCollection 2024. Gastroenterol Rep (Oxf). 2024. PMID: 39036068 Free PMC article. Review.
-
Surgical outcomes in elective sigmoid resection for diverticulitis stratified according to indication: a propensity-score matched cohort study with 903 patients.Langenbecks Arch Surg. 2023 Aug 3;408(1):295. doi: 10.1007/s00423-023-03034-9. Langenbecks Arch Surg. 2023. PMID: 37535118 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical