Elective surgery for diverticular disease: an audit of surgical pathology and treatment

Background: There is a need for a better classification of the surgical pathology of diverticular disease treated by elective resection. Methods: A prospective audit was conducted over a 25-year period, during which the surgeon studied the surgical pathology. The results of surgical treatment have been related to the pathology. Results: Two hundred and six patients were managed by elective resection with a postoperative mortality of 1.0% and a total morbidity of 51.5%. The surgical pathology was classified as: non-inflammatory 25 (12.6%), localized diverticulitis 90 (43.7%) and extracolic diverticulitis 90 (44.2%). Conclusions: This classification is useful to relate the technical requirements of surgery and the outcome to the surgical pathology. Postoperative morbidity is associated with the presence and severity of inflammatory pathology and therefore the casemix of any series will have a significant impact on this aspect.