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BACKGROUND

The optimal surgical management of acute diverticulitis is still a controversial and unresolved issue. While the Hartmann’s procedure () is the most commonly performed operation, primary anastomosis (PA), with or without proximal diversion, has also been used with increasing frequency.

METHODS

This is a National Surgical Quality Improvement Program database study including all patients requiring emergency surgery for acute diverticulitis. Three operative approaches were analyzed: HP, colectomy with PA, and colectomy with PA with proximal diversion (PAPD). Mortality and postoperative outcomes were compared between the three groups using a logistical regression model.

RESULTS

There were 1,314 patients who required emergent operation for acute diverticulitis, 75.4% underwent HP, 21.7% underwent PA, and 2.9% underwent PAPD. Thirty-day mortality was 7.3%, 4.6%, and 1.6% for HP …