J. L. Goldwag1,2, R. V. Lyn3, L. R. Wilson1,2, M. Z. Wilson1,2, S. J. Ivatury1,2 1Dartmouth Hitchcock Medical Center,The Department Of Surgery,Lebanon, NH, USA 2Dartmouth Medical School,Lebanon, NH, USA 3Dartmouth College,Hanover, NH, USA
Introduction:
Diverticular disease is common worldwide. A subset of these patients will choose to undergo elective surgical resection due to symptoms or complicated disease. The effect of elective sigmoid colon resection for diverticular disease on bowel function is unclear. The aim of this study is to evaluate changes in bowel function following elective sigmoid resection for diverticular disease.
Methods:
This is a prospective, observational study. We included all patients seen at our institution from May 2015 to July 2018 who underwent elective sigmoid resection for diverticular disease. We used the Colorectal Functional Outcome Questionnaire (COREFO), a validated bowel function questionnaire that assesses bowel function in five domains and a global function score. Scores range from zero to 100 with a higher score indicating worse function. We obtained questionnaire data at baseline as well as at postoperative follow-up. Patients were included if they completed both questionnaires and underwent elective sigmoid resection. Patients were excluded if they remained in bowel discontinuity or did not complete both questionnaires. A paired t-test was used to compare baseline and post-intervention scores.
Results:
49 patients met criteria for inclusion in this study. The median time between questionnaire completion was 70 days (IQR: 56 to 85). The mean age was 60 ± 12 years with 57% female patients. 36 (73%) patients underwent sigmoidectomy alone and 13 (27%) underwent sigmoidectomy with fistula repair. Six patients (12%) had a diverting loop ileostomy in addition to sigmoidectomy and underwent a subsequent reversal. Overall, there was no difference in Total COREFO score from baseline to post-intervention. There were also no differences in any of the five COREFO domains (Figure 1).
Conclusion:
Bowel function does not change in the postoperative period following elective sigmoid resection for diverticular disease. Surgeons should counsel patients, especially symptomatic ones, that bowel function will be no different at time of postoperative follow-up.
