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Session: ePoster: Benign Abdominal 11 (Sat315)

EP103 - Increased Recurrence Risk in Recurrent Diverticulitis and Improved Quality of Life with Surgery: A Systematic Review

Saturday, May 10, 2025
3:36 PM – 3:41 PM PT
Location: Monitor 1, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Kaiser O'Sahil Sadiq, MBBS (he/him/his)

    Research Fellow
    UC San Diego
    San Diego, CA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • RB

    Rishab Belavadi, MBBS

    Resident
    Mayo Clinic Arizona
    Phoenix, Arizona, United States

    Disclosure information not submitted.

  • SL

    Swetha Lakshminarayanan, N/A

    Research associate, Medical Graduate
    University of California San Diego, Sri Ramachandra Institute of Higher Education and Research
    Malden, Massachusetts, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Kaiser O'Sahil Sadiq, MBBS: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Background
The prevalence of diverticulitis has been increasing, with up to one-third of patients experiencing recurrence after an initial uncomplicated episode. In the past, routine sigmoid resection was commonly performed following a second uncomplicated episode. However, current guidelines now advocate for a more individualized approach. This review aims to examine the long-term outcomes of recurrent diverticulitis, emphasizing any differences between various treatment strategies.

Methods/Interventions: Methods
A systematic review was conducted using PRISMA guidelines and registered on PROSPERO. Cochrane Library, Embase, and Pubmed were searched for relevant publications in English published in the past 10 years. Observational studies and clinical trials were included if they reported outcomes for recurrent or persistent diverticulitis. Two independent reviewers screened the studies, appraised quality using the RoB2 tool and Newcastle-Ottawa Scale, and extracted data using standardized tables. A third reviewer resolved conflicts that arose.

Results/Outcomes: Results
The search strategy yielded 191 references, of which one randomized control trial (RCT) and three retrospective cohort studies were critically appraised (Fig. 1). All four studies were included for review and the extracted data has been tabulated in Table 1. The sample sizes ranged between 75 and 182 (median, 94.5), totaling 446 patients (42.1% male). Mean follow-up duration varied between 39.8 and 86.0 months for the three studies in which it was specified. Recurrence rates were available for three studies, ranging between 2.5-21.1%. Definitions for recurrent diverticulitis were inconsistent between the studies, and treatments employed included conservative measures and elective resection. Outcome measures reported included risk of recurrence, reinterventions, and quality of life (QoL) scores. Two studies found an increased recurrence risk in patients treated for persistent or recurrent diverticulitis. The reported incidence of surgery was higher in one study with persistent diverticulitis with a similar incidence of ostomy. The RCT showed higher reintervention rates in those who underwent surgery (21%) vs conservative management (4%). Using the Gastrointestinal QoL Questionnaire (GIQLI), surgery showed improved QoL in two studies, one of which found a significantly longer interval since the last episode.

Conclusion/Discussion: Conclusions
The recurrence rate and incidence of surgery are higher among individuals with persistent or recurrent diverticulitis. While surgical management enhances quality of life, it also raises the likelihood of requiring further interventions. Establishing standardized definitions for recurrent diverticulitis, stratified by frequency, will enable more accurate comparisons and could help update guidelines and create algorithms to assist in clinical decision-making.