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Erschienen in: International Journal of Colorectal Disease 5/2018

10.03.2018 | Original Article

Quality of life after laparoscopic sigmoid resection for uncomplicated diverticular disease

verfasst von: Lino Polese, Alice Bressan, Edoardo Savarino, Massimo Vecchiato, Angelo Turoldo, Annachiara Frigo, Giacomo Carlo Sturniolo, Nicolò De Manzini, Roberto Petri, Stefano Merigliano

Erschienen in: International Journal of Colorectal Disease | Ausgabe 5/2018

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Abstract

Purpose

The study aimed to evaluate the QoL in patients who underwent elective surgery for uncomplicated diverticulitis using a recently developed diverticulitis quality of life questionnaire (DV-QoL).

Methods

All consecutive patients who underwent surgery for uncomplicated diverticulitis or who were hospitalized and treated conservatively for acute uncomplicated diverticulitis episodes in three referral centers, in a 5-year period, were included in the study. The 36-Item Short Form Survey and the DV-QoL were administered to the patients to assess their QoL before and after treatment of diverticular disease.

Results

Ninety-seven patients who underwent surgery, 44 patients who were treated conservatively, and 44 healthy volunteers were included in the study. DV-QoL scores correlated with SF-36 scores (p < 0.0001). The surgically treated patients reported a worse quality of life before treatment with respect to the patients treated conservatively (mean 21.12 surgical vs 15.41 conservative, p = 0.0048). The surgically treated patients presented better post-treatment global scores with respect to the conservatively treated patients (mean: 6.90 surgical vs 10.61 conservative, p = 0.0186). Covariance analysis confirmed that the differences between the pre- and post-treatment DV-QoL scores were significantly higher in the surgical (p = 0.0002) with respect to the non-surgical patients. As far as single items were concerned, differences between the two groups were found in the pre- and post-treatment “concerns” and “behavioral changes” DV-QoL items.

Conclusions

Sigmoidectomy reduces concerns about diverticulitis and behavioral changes due to the disease. Quality of life should be considered when referring patients with uncomplicated diverticulitis to surgery. Prospective studies are required to confirm this result.
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Literatur
1.
Zurück zum Zitat Slack WW (1962) The anatomy, pathology, and some clinical features of divericulitis of the colon. Br J Surg 50:185–190CrossRefPubMed Slack WW (1962) The anatomy, pathology, and some clinical features of divericulitis of the colon. Br J Surg 50:185–190CrossRefPubMed
2.
Zurück zum Zitat Petruzziello L, Iacopini F, Bulajic M, Shah S, Costamagna G (2006) Review article: uncomplicated diverticular disease of the colon. Aliment Pharmacol Ther 23:1379–1391CrossRefPubMed Petruzziello L, Iacopini F, Bulajic M, Shah S, Costamagna G (2006) Review article: uncomplicated diverticular disease of the colon. Aliment Pharmacol Ther 23:1379–1391CrossRefPubMed
3.
4.
Zurück zum Zitat Custer TJ, Blevins DV, Vara TM (1999) Giant colonic diverticulum: a rare manifestation of a common disease. J Gastrointest Surg 3:543–548CrossRefPubMed Custer TJ, Blevins DV, Vara TM (1999) Giant colonic diverticulum: a rare manifestation of a common disease. J Gastrointest Surg 3:543–548CrossRefPubMed
5.
Zurück zum Zitat Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, Gemmen E, Shah S, Avdic A, Rubin R (2002) The burden of selected digestive diseases in the United States. Gastroenterology 122:1500–1511CrossRefPubMed Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, Gemmen E, Shah S, Avdic A, Rubin R (2002) The burden of selected digestive diseases in the United States. Gastroenterology 122:1500–1511CrossRefPubMed
6.
Zurück zum Zitat Painter NS, Burkitt DP (1975) Diverticular disease of the colon, a 20th century problem. Clin Gastroenterol 4:3–22PubMed Painter NS, Burkitt DP (1975) Diverticular disease of the colon, a 20th century problem. Clin Gastroenterol 4:3–22PubMed
7.
Zurück zum Zitat Schoetz DJ (1999) Diverticular disease of the colon: a century-old problem. Dis Colon Rectum 42:703–709CrossRefPubMed Schoetz DJ (1999) Diverticular disease of the colon: a century-old problem. Dis Colon Rectum 42:703–709CrossRefPubMed
8.
Zurück zum Zitat Parks TG (1975) Natural history of diverticular disease of the colon. Clin Gastroenterol 4:53–69PubMed Parks TG (1975) Natural history of diverticular disease of the colon. Clin Gastroenterol 4:53–69PubMed
9.
Zurück zum Zitat Tursi A, Picchio M, Elisei W, Di Mario F, Scarpignato C, Brandimarte G (2016) Management of patients with diverticulosis and diverticular disease: consensus statements from the 2nd international symposium on diverticular disease. J Clin Gastroenterol 50(Suppl 1):S101–S107CrossRefPubMed Tursi A, Picchio M, Elisei W, Di Mario F, Scarpignato C, Brandimarte G (2016) Management of patients with diverticulosis and diverticular disease: consensus statements from the 2nd international symposium on diverticular disease. J Clin Gastroenterol 50(Suppl 1):S101–S107CrossRefPubMed
10.
Zurück zum Zitat Regebongen SE, Hardiman KM, Hendren S, Morris AM. (2013) Surgery for diverticulitis in the 21 st century, a systematic review. JAMA surgery 2014 mar; 149 (3): 292-303 Clin Gastroenterol Hepatol 11:1532–1537 Regebongen SE, Hardiman KM, Hendren S, Morris AM. (2013) Surgery for diverticulitis in the 21 st century, a systematic review. JAMA surgery 2014 mar; 149 (3): 292-303 Clin Gastroenterol Hepatol 11:1532–1537
11.
Zurück zum Zitat Wolff BG, Boostrom SY (2012) Prophilactic resection, uncomplicated diverticulitis, and recurrent diverticulitis. Dig Dis 30:108–113CrossRefPubMed Wolff BG, Boostrom SY (2012) Prophilactic resection, uncomplicated diverticulitis, and recurrent diverticulitis. Dig Dis 30:108–113CrossRefPubMed
12.
Zurück zum Zitat Collins D, Winter DC (2008) Elective resection for diverticular disease: an evidence-based review. World J Surg 32:2429–2433CrossRefPubMed Collins D, Winter DC (2008) Elective resection for diverticular disease: an evidence-based review. World J Surg 32:2429–2433CrossRefPubMed
13.
Zurück zum Zitat Peery AF, Sandler RS (2013) Diverticular disease: reconsidering conventional wisdom. Clin Gastroenterol Hepatol 11:1532–1537CrossRefPubMed Peery AF, Sandler RS (2013) Diverticular disease: reconsidering conventional wisdom. Clin Gastroenterol Hepatol 11:1532–1537CrossRefPubMed
14.
Zurück zum Zitat Spiegel BM, Reid MW, Bolus R et al (2015) Development and validation of a disease-targeted quality of life instrument for chronic diverticular disease: the DV-QOL. Qual Life Res 24:163–179CrossRefPubMed Spiegel BM, Reid MW, Bolus R et al (2015) Development and validation of a disease-targeted quality of life instrument for chronic diverticular disease: the DV-QOL. Qual Life Res 24:163–179CrossRefPubMed
15.
Zurück zum Zitat Hinchey EJ, Schaal PG, Richards GK (1978) Treatment of perforated diverticular disease of the colon. Adv Surg 12:85–109PubMed Hinchey EJ, Schaal PG, Richards GK (1978) Treatment of perforated diverticular disease of the colon. Adv Surg 12:85–109PubMed
16.
Zurück zum Zitat Wong WD, Wexner SD, Lowry A et al (2000) Practice parameters for the treatment of sigmoid diverticulitis—supporting documentation. The standards task force. The American Society of Colon and Rectal Surgeons. Dis Colon Rectum 43:290–297CrossRefPubMed Wong WD, Wexner SD, Lowry A et al (2000) Practice parameters for the treatment of sigmoid diverticulitis—supporting documentation. The standards task force. The American Society of Colon and Rectal Surgeons. Dis Colon Rectum 43:290–297CrossRefPubMed
17.
Zurück zum Zitat Anaya DA, Flum DR (2005) Risk of emergency colectomy and colostomy in patients with diverticular disease. Arch Surg 140:681–685CrossRefPubMed Anaya DA, Flum DR (2005) Risk of emergency colectomy and colostomy in patients with diverticular disease. Arch Surg 140:681–685CrossRefPubMed
18.
Zurück zum Zitat Chapman J, Davies M, Wolfe B et al (2005) Complicated diverticulitis. Is it time to rethink the rules? Ann Surg 242:576–581PubMedPubMedCentral Chapman J, Davies M, Wolfe B et al (2005) Complicated diverticulitis. Is it time to rethink the rules? Ann Surg 242:576–581PubMedPubMedCentral
19.
Zurück zum Zitat Schultz JK, Yaqub S, Øresland T (2016) Management of diverticular disease in Scandinavia. J Clin Gastroenterol 50:S50–S52CrossRefPubMed Schultz JK, Yaqub S, Øresland T (2016) Management of diverticular disease in Scandinavia. J Clin Gastroenterol 50:S50–S52CrossRefPubMed
20.
Zurück zum Zitat Andersen JC, Bundgaard L, Elbrønd H, Laurberg S, Walker LR, Støvring J, Danish Surgical Society (2012) Danish national guidelines for treatment of diverticular disease. Dan Med J 59:C4453PubMed Andersen JC, Bundgaard L, Elbrønd H, Laurberg S, Walker LR, Støvring J, Danish Surgical Society (2012) Danish national guidelines for treatment of diverticular disease. Dan Med J 59:C4453PubMed
21.
22.
Zurück zum Zitat Rafferty J, Shellito P, Hyman NH, Buie WD (2006) Standards Committee of American Society of colon and rectal surgeons. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum 49:939–944CrossRefPubMed Rafferty J, Shellito P, Hyman NH, Buie WD (2006) Standards Committee of American Society of colon and rectal surgeons. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum 49:939–944CrossRefPubMed
23.
Zurück zum Zitat Cuomo R, Barbara G, Pace F, Annese V, Bassotti G, Binda GA, Casetti T, Colecchia A, Festi D, Fiocca R, Laghi A, Maconi G, Nascimbeni R, Scarpignato C, Villanacci V, Annibale B (2014) Italian consensus conference for colonic diverticulosis and diverticular disease. United Eur Gastrenterol J 2:413–422CrossRef Cuomo R, Barbara G, Pace F, Annese V, Bassotti G, Binda GA, Casetti T, Colecchia A, Festi D, Fiocca R, Laghi A, Maconi G, Nascimbeni R, Scarpignato C, Villanacci V, Annibale B (2014) Italian consensus conference for colonic diverticulosis and diverticular disease. United Eur Gastrenterol J 2:413–422CrossRef
24.
Zurück zum Zitat Binda GA, Cuomo R, Laghi A, Nascimbeni R, Serventi A, Bellini D, Gervaz P, Annibale B, Italian Society of Colon and Rectal Surgery (2015) Italian society of colon and rectal surgery. Practice parameters for the treatment of colonic diverticular disease: Italian society of colon rectal surgery (SICCR) guidelines. Tech Coloproctol 19:615–626CrossRefPubMed Binda GA, Cuomo R, Laghi A, Nascimbeni R, Serventi A, Bellini D, Gervaz P, Annibale B, Italian Society of Colon and Rectal Surgery (2015) Italian society of colon and rectal surgery. Practice parameters for the treatment of colonic diverticular disease: Italian society of colon rectal surgery (SICCR) guidelines. Tech Coloproctol 19:615–626CrossRefPubMed
25.
Zurück zum Zitat Andeweg CS, Mulder IM, Felt-Bersma RJ, et al. Netherlands Society of Surgery; working group from Netherlands societies of internal medicine, gastroenterologists, radiology, health technology assessment and dieticians. (2013) Guidelines of diagnostic and treatment of acute left-sided colonic diverticulitis. Dig Surg 30: 278–292 Andeweg CS, Mulder IM, Felt-Bersma RJ, et al. Netherlands Society of Surgery; working group from Netherlands societies of internal medicine, gastroenterologists, radiology, health technology assessment and dieticians. (2013) Guidelines of diagnostic and treatment of acute left-sided colonic diverticulitis. Dig Surg 30: 278–292
26.
Zurück zum Zitat Feingold D, Steele SR, Lee S, Kaiser A, Boushey R, Buie WD, Rafferty JF (2014) Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon rectum 57:284–294CrossRefPubMed Feingold D, Steele SR, Lee S, Kaiser A, Boushey R, Buie WD, Rafferty JF (2014) Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon rectum 57:284–294CrossRefPubMed
27.
Zurück zum Zitat Vennix S, Morton DG, Hahnloser D, Lange JF, Bemelman WA (2014) Research committee of the European society of coloproctocology. Systematic review of evidence and consensus on diverticulitis: an analysis of national and international guidelines. Color Dis 16:866–878CrossRef Vennix S, Morton DG, Hahnloser D, Lange JF, Bemelman WA (2014) Research committee of the European society of coloproctocology. Systematic review of evidence and consensus on diverticulitis: an analysis of national and international guidelines. Color Dis 16:866–878CrossRef
29.
Zurück zum Zitat Egger B, Peter MK, Candinas D (2008) Persistent symptoms after elective sigmoid resection for diverticulitis. Dis Colon rectum 51:1044–1048CrossRefPubMed Egger B, Peter MK, Candinas D (2008) Persistent symptoms after elective sigmoid resection for diverticulitis. Dis Colon rectum 51:1044–1048CrossRefPubMed
30.
Zurück zum Zitat Bianchi M, Festa V, Moretti A, Ciaco A, Mangone M, Tornatore V, Dezi A, Luchetti R, de Pascalis B, Papi C, Koch M (2011) Meta-analysis: longterm therapy with rifaximin in the management of uncomplicated diverticular disease. Aliment Pharmacol Ther 33:902–910CrossRefPubMed Bianchi M, Festa V, Moretti A, Ciaco A, Mangone M, Tornatore V, Dezi A, Luchetti R, de Pascalis B, Papi C, Koch M (2011) Meta-analysis: longterm therapy with rifaximin in the management of uncomplicated diverticular disease. Aliment Pharmacol Ther 33:902–910CrossRefPubMed
31.
Zurück zum Zitat Colecchia A, Vestito A, Pasqui F, Mazzella G, Roda E, Pistoia F, Brandimarte G, Festi D (2007) Efficacy of longterm administration of the poorly adsorbed antibiotic Rfaximin, in symptomatic, uncomplicated colonic diverticular disease. World J Gastroenterol (13):264–269 Colecchia A, Vestito A, Pasqui F, Mazzella G, Roda E, Pistoia F, Brandimarte G, Festi D (2007) Efficacy of longterm administration of the poorly adsorbed antibiotic Rfaximin, in symptomatic, uncomplicated colonic diverticular disease. World J Gastroenterol (13):264–269
32.
Zurück zum Zitat Tursi A, Brandimarte G, Elisei W, Picchio M, Forti G, Pianese G, Rodino S, D'Amico T, Sacca N, Portincasa P, Capezzuto E, Lattanzio R, Spadaccini A, Fiorella S, Polimeni F, Polimeni N, Stoppino V, Stoppino G, Giorgetti GM, Aiello F, Danese S (2013) Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease—a double-blind, randomised, placebo-controlled study. Aliment Pharmacol Ther 38:741–751CrossRefPubMed Tursi A, Brandimarte G, Elisei W, Picchio M, Forti G, Pianese G, Rodino S, D'Amico T, Sacca N, Portincasa P, Capezzuto E, Lattanzio R, Spadaccini A, Fiorella S, Polimeni F, Polimeni N, Stoppino V, Stoppino G, Giorgetti GM, Aiello F, Danese S (2013) Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease—a double-blind, randomised, placebo-controlled study. Aliment Pharmacol Ther 38:741–751CrossRefPubMed
33.
Zurück zum Zitat Scarpa M, Griggio L, Rampado S, Ruffolo C, Citton M, Pozza A, Borsetto L, Dall’Olmo L, Angriman I (2011) Long-term health–related quality of life after minimally invasive surgery for diverticular disease. Langenbeck's Arch Surg 396:833–843CrossRef Scarpa M, Griggio L, Rampado S, Ruffolo C, Citton M, Pozza A, Borsetto L, Dall’Olmo L, Angriman I (2011) Long-term health–related quality of life after minimally invasive surgery for diverticular disease. Langenbeck's Arch Surg 396:833–843CrossRef
34.
Zurück zum Zitat Venara A, Toqué L, Barbieux J, Cesbron E, Ridereau-Zins C, Lermite E, Hamy A (2015) Sigmoid stricture associated with diverticular disease should be an indication for elective surgery with lymph node clear. J Visc Surg 152:211–215CrossRefPubMed Venara A, Toqué L, Barbieux J, Cesbron E, Ridereau-Zins C, Lermite E, Hamy A (2015) Sigmoid stricture associated with diverticular disease should be an indication for elective surgery with lymph node clear. J Visc Surg 152:211–215CrossRefPubMed
35.
Zurück zum Zitat Jackson JD, Hammond T (2014) Systematic review: outpatient management of acute uncomplicated diverticulitis. Int J Color Dis 29:775–781CrossRef Jackson JD, Hammond T (2014) Systematic review: outpatient management of acute uncomplicated diverticulitis. Int J Color Dis 29:775–781CrossRef
Metadaten
Titel
Quality of life after laparoscopic sigmoid resection for uncomplicated diverticular disease
verfasst von
Lino Polese
Alice Bressan
Edoardo Savarino
Massimo Vecchiato
Angelo Turoldo
Annachiara Frigo
Giacomo Carlo Sturniolo
Nicolò De Manzini
Roberto Petri
Stefano Merigliano
Publikationsdatum
10.03.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Colorectal Disease / Ausgabe 5/2018
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-018-3005-y

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