Surgeon specialization impacts the management but not outcomes of acute complicated diverticulitis

• Published in: The American journal of surgery Vol. 211; no. 6; pp. 1035 - 1040
• Main Authors: Wright, G. Paul, M.D, Flermoen, Stephanie L., M.D, Robinett, Danielle M., M.D, Charney, Kira N., M.D, Chung, Mathew H., M.D., F.A.C.S
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2016; Elsevier Limited
• Subjects: Acute Disease; Adult; Aged; Antibiotics; Body mass index; Classification; Cohort Studies; Colorectal surgery; Colorectal Surgery - standards; Colorectal Surgery - trends; Comorbidity; Complicated diverticulitis; Diverticulitis; Diverticulitis, Colonic - diagnosis; Diverticulitis, Colonic - mortality; Diverticulitis, Colonic - surgery; Diverting ileostomy; Female; Follow-Up Studies; General Surgery - standards; General Surgery - trends; Hartmann's procedure; Heart attacks; Hinchey; Hospital Mortality; Hospitals; Humans; Intensive care; Logistic Models; Male; Medical personnel; Middle Aged; Morbidity; Mortality; Multivariate Analysis; Operative Time; Ostomy; Postoperative Complications - mortality; Postoperative Complications - physiopathology; Retrospective Studies; Risk Assessment; Severity of Illness Index; Specialization; Specialties, Surgical; Statistics, Nonparametric; Surgery; Survival Analysis; Treatment Outcome; Variables; United States > US; Hartmann's procedure; Hinchey; Diverticulitis; Diverting ileostomy; Complicated diverticulitis
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2015.10.010

Abstract Background The management and outcomes of patients receiving nonelective surgical treatment of acute complicated diverticulitis by surgeon specialization have received little attention. Methods A retrospective review was performed of consecutive patients with acute complicated diverticulitis who underwent surgery from 2006 to 2013. Patients were analyzed based on surgeon specialty: general surgery (GS) or colorectal surgery (CRS). Results One hundred fifteen patients met criteria for study; 62 patients in the CRS and 53 in the GS group. GS were more likely to perform Hartmann's procedures or primary anastomosis and less likely to perform primary anastomosis with diverting ileostomy than CRS. There were no differences between groups for any outcome measures on univariate analysis. CRS patients had shorter operative time ( P = .001) and length of stay ( P ≤ .001) for stoma reversal procedures. Surgeon specialization was not associated with morbidity, readmission, or length of stay on multivariate analysis. Conclusions Although surgical management differed significantly between CRS and GS, comparable outcomes were observed at the index hospital admission.