Clinical and Economic Insights Into Surgery for Colonic Diverticular Perforation: A Long-Term Observational Cohort Study

Aim

The clinical characteristics of colonic diverticular perforation are poorly understood. We aimed to clarify the clinical characteristics of colonic diverticular perforation.

Methods

Patients who underwent surgery for colonic diverticular perforation from 2011 to 2021 were retrospectively evaluated. The patients were divided into right- and left-sided colon cohorts according to their perforation location.

Results

Of 1129 patients with gastrointestinal perforation, 138 had colonic diverticular perforation. The sigmoid colon was the most common perforation site. The patients were categorized into right-sided (20 patients) and left-sided (118 patients) colon cohorts. The number of patients with colonic diverticular perforation increased with age, as did the proportion of left-sided perforations. The left-sided cohort had significantly higher mean age, hemoglobin, and serum albumin levels than the right-sided cohort. The blood urea nitrogen and serum creatinine levels were significantly lower in the right-sided cohort. The proportion of patients with colostomy, the proportion of patients with postoperative complications, and the length of intensive care unit stay during hospitalization were significantly longer in the left-sided cohort. The left-sided cohort also had a considerably longer mean hospital stay and higher mean hospitalization costs than the right-sided colon cohort. An age of ≥ 75 years tended to be associated with a prolonged hospital stay and high hospitalization costs in the left-sided colon cohort.

Conclusions

The patients' conditions, length of hospital stay, and hospitalization costs were significantly worse in the left- than right-sided colon cohort. The clinical characteristics differed according to the location of the diverticular perforation.