Timing of rectosigmoid resection for diverticular disease: the patient’s view

Aim  The study aimed to determine the patient’s view on the timing of elective resection for sigmoid diverticulitis. Method  A questionnaire was answered by 162 (69%) of 236 consecutive patients who had a resection of the rectosigmoid for diverticulitis from July 2002 to August 2005. Patients (n = 45) having resection at or after the first inflammatory attack were excluded, leaving 117 eligible for analysis. Questions asked included those concerning symptoms before surgery, improvement of symptoms after surgery and the timing of surgery. Results  Patient assessment of symptoms after surgery was as follows: no improvement (2%; n = 2), some improvement (10%; n = 12), marked improvement (34%; n = 39) and complete resolution (54%; n = 63). Forty-five (38%) patients would have preferred an earlier operation. Preference for earlier surgery related to the number of previous inflammatory attacks was expressed as follows: 13 (34%) of 38 patients after two inflammatory attacks, 5 (18%) of 28 patients after three, seven (37%) of 19 patients after four, four (44%) of nine patients after five, and 16 (70%) of 23 patients after six or more inflammatory attacks would have preferred earlier surgery. Statistically significant factors influencing this potential choice were number of episodes of pain (P = 0.006, OR = 1.23, 95% CI: 1.060–1.430) and number of attacks of inflammation (P = 0.048, OR = 1.27, 95% CI: 1.002–1.598). Conclusion  Surgery for recurrent diverticulitis resulted in a marked improvement or complete relief of symptoms in 88% of patients. A large proportion of patients with recurrent episodes of sigmoid diverticulitis would have preferred earlier resection.