Rethinking elective colectomy for diverticulitis: A strategic approach to population health

Vlad V. Simianu, David R. Flum

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Diverticulitis is one of the leading indications for elective colon resection. Surgeons are trained to offer elective operations after a few episodes of diverticulitis in order to prevent future recurrences and potential emergency. However, most emergency surgery happens during the initial presentation. After recovery from an episode, much of the subsequent management of diverticulitis occurs in the outpatient setting, rendering inpatient "episode counting" a poor measure of the severity or burden of disease. Evidence also suggests that the risk of recurrence of diverticulitis is small and similar with or without an operation. Accordingly, contemporary evaluations of the epidemiologic patterns of treatments for diverticulitis have failed to demonstrate that the substantial rise in elective surgery over the last few decades has been successful at preventing emergency surgery at a population level. Multiple professional societies are calling to "individualize" decisions for elective colectomy and there is an international focus on "appropriate" indications for surgery. The rethinking of elective colectomy should come from a patient-centered approach that considers the risks of recurrence, quality of life, patient wishes and experiences about surgical and medical treatment options as well as operative morbidity and risks.

Original languageEnglish (US)
Pages (from-to)16609-16614
Number of pages6
JournalWorld journal of gastroenterology
Issue number44
StatePublished - Nov 28 2014
Externally publishedYes

Bibliographical note

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© 2014 Baishideng Publishing Group Inc. All rights reserved.


  • Appropriate
  • Colectomy
  • Colostomy
  • Diverticulitis
  • Elective
  • Indications
  • Laparoscopy
  • Quality of life


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