February 10, 2022

Diverticulitis surgery: guidelines needed

Surgical removal of the colon for recurrent diverticulosis varies by geographic region and is associated with surgeon and hospital factors; stronger national guidelines are needed, Vanderbilt researchers report.

by Bill Snyder

Each year in the United States, diverticulitis, inflammation of abnormal pouches — diverticula — in the wall of the large intestine, accounts for nearly 300,000 hospital admissions and $1.8 billion in direct medical costs. 

Because of the risk that an inflamed diverticulum can rupture, infecting the abdominal cavity, patients with recurrent diverticulitis often undergo elective resection to remove the affected part of the colon. However, strong clinical practice guidelines for this procedure, which is also performed to improve quality of life, are lacking. 

Using Medicare data to evaluate variation in rates of elective colon resection for diverticular disease, Alexander Hawkins, MD, MPH, and colleagues found the procedure was conducted more frequently in hospital referral regions with a greater density of surgeons, large for-profit and teaching hospitals in metropolitan areas, and lower levels of competition. 

Their analysis, published in the Annals of Surgery, should be a “call to action” to develop strong clinical practice guidelines to define best practice in this complex population of patients.

This research was supported by the National Institutes of Health (grant DK118192), American Cancer Society and Urology Care Foundation.