Impact of early or delayed elective resection in complicated diverticulitis

Table 1 Patient characteristics n (%)

	Early elective resection (n = 272)	Delayed elective resection (n = 149)	P value
Age (mean ± SD)	63.5 ± 13.1	64.2 ± 12.6	0.57
Sex
Male	121 (44.5)	63 (42.3)	0.66
Female	151 (55.5)	86 (57.7)
Classification of diverticulitis
Hinchey 1	230 (84.6)	132 (88.6)	0.28
Hinchey 2	42 (15.4)	17 (11.4)
ASA classification
ASA 1	10 (3.7)	4 (2.7)	0.69
ASA 2	150 (55.1)	89 (59.7)
ASA 3	107 (39.3)	52 (34.9)
ASA 4	5 (1.8)	4 (2.7)

ASA: American Society of Anesthesiologists.

Table 2 Outcome following early and delayed elective resections performed for complicated diverticulitis n (%)

	Early elective resection(n = 272)	Delayed elective resection performed (n = 141)	P value
Operation
Minimally invasive surgery	204 (75.0)	119 (84.4)	0.032
Open surgery	68 (25.0)	22 (15.6)
Procedure
Hartman	1 (0.4)	0 (0.0)	0.75
Protective stoma	17 (6.3)	8 (5.7)
Primary anastomosis without stoma	254 (93.4)	133 (94.3)
Surgical complications
Wound infection	30 (11.0)	10 (7.1)	0.22
Anastomotic leakage	14 (5.1)	6 (4.3)	0.81
Reoperation	22 (8.1)	8 (5.7)	0.43
Medical complications
Uriary tract infection	16 (5.9)	7 (5.0)	0.82
Pneumonia	9 (3.3)	4 (2.8)	1
Overall morbidity	41 (15.1)	16 (11.3)	0.16
Mortality	1 (0.4)	1 (0.7)	1
Socioeconomic data (mean ± SD)
Duration of hospital stay (d)	16.1 ± 9.0	13.3 ± 7.9	0.002
Duration of operation (min)	166.2 ± 44.2	149.1 ± 39.1	< 0.001
Duration of ICU stay (d)	0.64 ± 0.90	0.72 ± 0.91	0.47
Overall costs (€)	8423 ± 968	9296 ± 694	< 0.001

ICU: Intensive care unit.

Table 3 Outcome of planned early and delayed elective resections for complicated diverticulitis (intention to treat analysis) n (%)

	Early elective resection(n = 272)	Planned for delayed elective resection1 (n = 149)	P value
Operation
Minimally invasive surgery	204 (75.0)	119 (79.9)	0.28
Open surgery	68 (25.0)	30 (20.1)
Procedure
Hartman	1 (0.4)	3 (2.0)	0.153
Protective stoma	17 (6.3)	13 (8.7)
Primary anastomosis without stoma	254 (93.4)	133 (89.3)
Surgical complications
Wound infection	30 (11.0)	16 (10.7)	0.92
Anastomotic leakage	14 (5.1)	8 (5.4)	1.0
Reoperation	22 (8.1)	12 (8.1)	1.0
Medical complications
Uriary tract infection	16 (5.9)	7 (4.7)	0.66
Pneumonia	9 (3.3)	5 (3.4)	1.0
Overall morbidity	41 (15.1)	23 (15.4)	0.92
Mortality	1 (0.4)	2 (1.3)	0.26
Socioeconomic data (mean ± SD)
Duration of hospital stay (d)	16.1 ± 9.0	14.2 ± 10.0	0.043
Duration of operation (min)	166.2 ± 44.2	148.9 ± 38.4	< 0.001
Duration of ICU stay (d)	0.64 ± 0.90	1.4 ± 4.0	0.004
Overall costs (€)	8423 ± 968	9941 ± 3563	< 0.001

¹It includes the eight patients who required emergency surgery during the period of 6-8 wk whilst awaiting elective surgery. ICU: Intensive care unit.