Outcomes and Quality of Life After Elective Laparoscopic Resection for Diverticular Disease of the Colon

Outcomes and Quality of Life After Elective Laparoscopic Resection for Diverticular Disease of the Colon | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Outcomes and Quality of Life After Elective Laparoscopic Resection for Diverticular Disease of the Colon Alessandro Verbo, Mattia Angelo Bez, Danilo Di Giorgio, Iacopo Verbo This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7945193/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Elective laparoscopic resection is an established treatment for recurrent or symptomatic diverticular disease. This study evaluated clinical outcomes and postoperative quality of life after elective colonic resection. Methods This single-center retrospective study included 36 patients who underwent surgery between August 2023 and August 2025 at the Mater Olbia Hospital. Clinical, intraoperative, and postoperative data were analyzed with a median follow-up of 24 months. Primary endpoints were morbidity and length of stay; secondary endpoints included conversion, anastomotic leak, and quality-of-life scores (EQ-5D, GIQLI, LARS). Results Laparoscopic surgery was performed in 86% of cases with a 13.9% conversion rate. Mean operative time was 95 ± 29 minutes, blood loss 121 ± 81 mL, and hospital stay 7 [6–7] days. No major complications (Clavien–Dindo ≥ II) occurred. Laparoscopy was associated with shorter operative time, lower blood loss, and reduced hospital stay (p < 0.05). Conclusions Elective laparoscopic resection for diverticular disease is safe, effective, and provides favorable postoperative quality of life with low morbidity. General Surgery diverticular disease laparoscopic resection quality of life GIQLI EQ-5D LARS Introduction Elective laparoscopic sigmoid resection is widely adopted for recurrent or persistent symptomatic diverticular disease. The present study evaluates perioperative outcomes and postoperative quality of life following elective sigmoid resection in a single-center cohort. Methods Study design: Retrospective observational study conducted at the Department of General Surgery, Mater Olbia Hospital (August 2023–August 2025). Inclusion criteria: symptomatic diverticular disease or recurrent diverticulitis (Hinchey I–II), elective sigmoid resection with or without primary anastomosis, complete data, follow-up ≥ 1 month. Exclusion criteria: concomitant malignancy, emergency procedures (Hinchey III–IV), combined operations, incomplete datasets, or ongoing immunosuppression. Data collection and outcomes: Demographic, clinical, intraoperative, and postoperative data were recorded. Primary endpoints were postoperative morbidity and hospital stay; secondary endpoints included conversion, anastomotic leak, and quality-of-life scores (EQ-5D, GIQLI, LARS, NRS pain, satisfaction). Statistical analysis: Analyses were performed using IBM SPSS Statistics v29. Continuous variables are expressed as mean ± standard deviation (SD) or median [IQR]. Group comparisons (laparoscopic vs open) used Student’s t-test or Mann–Whitney U test; categorical variables used χ². Significance was set at p < 0.05. Results A total of 36 patients were included (mean age 64 ± 11 years; 22 females). Table 1 summarizes baseline characteristics. A laparoscopic approach was used in 31 patients (86%), with a conversion rate of 13.9%. Operative time averaged 95 ± 29 minutes, blood loss 121 ± 81 mL, and median hospital stay 7 [6–7] days (Table 2). No intraoperative adverse events occurred. No major complications (Clavien–Dindo ≥ II) were reported. Anastomotic leak occurred in 5.6%, postoperative ileus in 2.8%, and reoperation in 5.6%. No readmissions were recorded within 30 days. Quality-of-life outcomes were favorable (EQ-5D 0.55 ± 0.14; GIQLI 96.2 ± 17.6; LARS 15.1 ± 8.8) (Table 3). Laparoscopic surgery was associated with significantly reduced operative time, blood loss, and length of stay (p < 0.05). No significant correlations were found between ASA class or comorbidities and complications. Discussion This study confirms the safety and effectiveness of elective laparoscopic resection for diverticular disease, with low morbidity and short hospitalization. The laparoscopic approach offered advantages in operative time, blood loss, and hospital stay, consistent with previous literature. Quality-of-life outcomes were favorable, and postoperative bowel function impairment was mild. Limitations include the retrospective single-center design and modest sample size, which limit generalizability. Nonetheless, the findings align with recent multicenter evidence supporting laparoscopic resection as a safe and beneficial strategy for selected patients. Conclusions Elective laparoscopic resection for diverticular disease is safe and effective, yielding low complication rates and satisfactory postoperative quality of life. Standardized perioperative management may further optimize results. Declarations Ethical Approval Approved by the Institutional Review Board of Mater Olbia Hospital; informed consent was waived due to the retrospective design. Conflict of Interest The authors declare no conflicts of interest. Funding No external funding was received. Author Contributions Conceptualization: A.V., M.A.B.; Data curation: M.A.B., D.D.G.; Formal analysis: A.V., M.A.B.; Investigation: M.A.B., D.D.G.; Methodology: A.V., M.A.B.; Supervision: A.V.; Writing—original draft: A.V., M.A.B.; Writing—review & editing: D.D.G., I.V. References Gaertner WB, Kwaan MR, Madoff RD, Melton GB. Diverticulitis: a review. World J Surg 2013;37:629-38. Lin M, et al. Laparoscopic colectomy for diverticulitis. J Clin Med 2018;7:345. Santos A, et al. Laparoscopic vs open resection for diverticular disease. JAMA Surg 2023;158:593-601. Khan RMA, et al. Surgical outcomes in diverticular disease. Int J Colorectal Dis 2017;32:1145-56. Eltyeb HA, et al. Laparoscopic colectomy outcomes. Tech Coloproctol 2025;29:121. Andeweg CS, et al. Review of diverticulitis management. Colorectal Dis 2016;18:O1-12. Cirocchi R, et al. Meta-analysis of laparoscopic sigmoidectomy. Surg Endosc 2024;38:2241-52. Sarraj A, et al. Functional outcomes after resection. Colorectal Dis 2023;25:1920-9. Tursi A, et al. Quality of life in diverticular disease. Int J Colorectal Dis 2025;40:321-34. Vennix S, et al. Laparoscopic sigmoid resection for diverticulitis. Ann Surg 2022;276:641-50. Tables Table 1. Preoperative Characteristics Age (mean ± SD): 64.0 ± 11.0 years Sex (F/M): 22/14 BMI (mean ± SD): 23.7 ± 5.0 kg/m² ASA (I–II–III–IV): 12/13/11/0 Comorbidities: None (16), Hypertension (12), Others (8) Symptoms: Pain (25%), Rectal bleeding (11%), Peritonism (3%) Table 2. Operative Details Laparoscopic/Open approach: 31/5 Conversions: 13.9% Operative time (mean ± SD): 95.3 ± 29.3 min Blood loss (mean ± SD): 121.1 ± 81.0 mL Hospital stay (median [IQR]): 7 [6–7] days Table 3. Postoperative Outcomes and Quality of Life Clavien–Dindo ≥ II complications: 0.0% Anastomotic leak: 5.6% Postoperative ileus: 2.8% Reoperation: 5.6% 30-day readmission: 0.0% EQ-5D (mean ± SD): 0.55 ± 0.14 GIQLI (mean ± SD): 96.2 ± 17.6 LARS (mean ± SD): 15.1 ± 8.8 Pain NRS (mean ± SD): 2.4 ± 1.9 Satisfaction (median [IQR]): 3 [2–4] Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Colon\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eElective laparoscopic sigmoid resection is widely adopted for recurrent or persistent symptomatic diverticular disease. The present study evaluates perioperative outcomes and postoperative quality of life following elective sigmoid resection in a single-center cohort.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy design: Retrospective observational study conducted at the Department of General Surgery, Mater Olbia Hospital (August 2023\u0026ndash;August 2025).\u003c/p\u003e\u003cp\u003eInclusion criteria: symptomatic diverticular disease or recurrent diverticulitis (Hinchey I\u0026ndash;II), elective sigmoid resection with or without primary anastomosis, complete data, follow-up \u0026ge;\u0026thinsp;1 month.\u003c/p\u003e\u003cp\u003eExclusion criteria: concomitant malignancy, emergency procedures (Hinchey III\u0026ndash;IV), combined operations, incomplete datasets, or ongoing immunosuppression.\u003c/p\u003e\u003cp\u003eData collection and outcomes: Demographic, clinical, intraoperative, and postoperative data were recorded. Primary endpoints were postoperative morbidity and hospital stay; secondary endpoints included conversion, anastomotic leak, and quality-of-life scores (EQ-5D, GIQLI, LARS, NRS pain, satisfaction).\u003c/p\u003e\u003cp\u003eStatistical analysis: Analyses were performed using IBM SPSS Statistics v29. Continuous variables are expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) or median [IQR]. Group comparisons (laparoscopic vs open) used Student\u0026rsquo;s t-test or Mann\u0026ndash;Whitney U test; categorical variables used χ\u0026sup2;. Significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 36 patients were included (mean age 64\u0026thinsp;\u0026plusmn;\u0026thinsp;11 years; 22 females). Table\u0026nbsp;1 summarizes baseline characteristics. A laparoscopic approach was used in 31 patients (86%), with a conversion rate of 13.9%. Operative time averaged 95\u0026thinsp;\u0026plusmn;\u0026thinsp;29 minutes, blood loss 121\u0026thinsp;\u0026plusmn;\u0026thinsp;81 mL, and median hospital stay 7 [6\u0026ndash;7] days (Table\u0026nbsp;2). No intraoperative adverse events occurred.\u003c/p\u003e\u003cp\u003eNo major complications (Clavien\u0026ndash;Dindo\u0026thinsp;\u0026ge;\u0026thinsp;II) were reported. Anastomotic leak occurred in 5.6%, postoperative ileus in 2.8%, and reoperation in 5.6%. No readmissions were recorded within 30 days. Quality-of-life outcomes were favorable (EQ-5D 0.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.14; GIQLI 96.2\u0026thinsp;\u0026plusmn;\u0026thinsp;17.6; LARS 15.1\u0026thinsp;\u0026plusmn;\u0026thinsp;8.8) (Table\u0026nbsp;3).\u003c/p\u003e\u003cp\u003eLaparoscopic surgery was associated with significantly reduced operative time, blood loss, and length of stay (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No significant correlations were found between ASA class or comorbidities and complications.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study confirms the safety and effectiveness of elective laparoscopic resection for diverticular disease, with low morbidity and short hospitalization. The laparoscopic approach offered advantages in operative time, blood loss, and hospital stay, consistent with previous literature. Quality-of-life outcomes were favorable, and postoperative bowel function impairment was mild.\u003c/p\u003e\u003cp\u003eLimitations include the retrospective single-center design and modest sample size, which limit generalizability. Nonetheless, the findings align with recent multicenter evidence supporting laparoscopic resection as a safe and beneficial strategy for selected patients.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eElective laparoscopic resection for diverticular disease is safe and effective, yielding low complication rates and satisfactory postoperative quality of life. Standardized perioperative management may further optimize results.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eEthical Approval\u003c/h2\u003e\u003cp\u003e Approved by the Institutional Review Board of Mater Olbia Hospital; informed consent was waived due to the retrospective design.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003cp\u003eThe authors declare no conflicts of interest.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eNo external funding was received.\u003c/p\u003e\u003ch2\u003eAuthor Contributions\u003c/h2\u003e\u003cp\u003eConceptualization: A.V., M.A.B.; Data curation: M.A.B., D.D.G.; Formal analysis: A.V., M.A.B.; Investigation: M.A.B., D.D.G.; Methodology: A.V., M.A.B.; Supervision: A.V.; Writing\u0026mdash;original draft: A.V., M.A.B.; Writing\u0026mdash;review \u0026amp; editing: D.D.G., I.V.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGaertner WB, Kwaan MR, Madoff RD, Melton GB. Diverticulitis: a review. World J Surg 2013;37:629-38.\u003c/li\u003e\n\u003cli\u003eLin M, et al. Laparoscopic colectomy for diverticulitis. J Clin Med 2018;7:345.\u003c/li\u003e\n\u003cli\u003eSantos A, et al. Laparoscopic vs open resection for diverticular disease. JAMA Surg 2023;158:593-601.\u003c/li\u003e\n\u003cli\u003eKhan RMA, et al. Surgical outcomes in diverticular disease. Int J Colorectal Dis 2017;32:1145-56.\u003c/li\u003e\n\u003cli\u003eEltyeb HA, et al. Laparoscopic colectomy outcomes. Tech Coloproctol 2025;29:121.\u003c/li\u003e\n\u003cli\u003eAndeweg CS, et al. Review of diverticulitis management. Colorectal Dis 2016;18:O1-12.\u003c/li\u003e\n\u003cli\u003eCirocchi R, et al. Meta-analysis of laparoscopic sigmoidectomy. Surg Endosc 2024;38:2241-52.\u003c/li\u003e\n\u003cli\u003eSarraj A, et al. Functional outcomes after resection. Colorectal Dis 2023;25:1920-9.\u003c/li\u003e\n\u003cli\u003eTursi A, et al. Quality of life in diverticular disease. Int J Colorectal Dis 2025;40:321-34.\u003c/li\u003e\n\u003cli\u003e Vennix S, et al. Laparoscopic sigmoid resection for diverticulitis. Ann Surg 2022;276:641-50.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Preoperative Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAge (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD): 64.0\u0026thinsp;\u0026plusmn;\u0026thinsp;11.0 years\u003c/p\u003e\n\u003cp\u003eSex (F/M): 22/14\u003c/p\u003e\n\u003cp\u003eBMI (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD): 23.7\u0026thinsp;\u0026plusmn;\u0026thinsp;5.0 kg/m\u0026sup2;\u003c/p\u003e\n\u003cp\u003eASA (I\u0026ndash;II\u0026ndash;III\u0026ndash;IV): 12/13/11/0\u003c/p\u003e\n\u003cp\u003eComorbidities: None (16), Hypertension (12), Others (8)\u003c/p\u003e\n\u003cp\u003eSymptoms: Pain (25%), Rectal bleeding (11%), Peritonism (3%)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;2. Operative Details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLaparoscopic/Open approach: 31/5\u003c/p\u003e\n\u003cp\u003eConversions: 13.9%\u003c/p\u003e\n\u003cp\u003eOperative time (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD): 95.3\u0026thinsp;\u0026plusmn;\u0026thinsp;29.3 min\u003c/p\u003e\n\u003cp\u003eBlood loss (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD): 121.1\u0026thinsp;\u0026plusmn;\u0026thinsp;81.0 mL\u003c/p\u003e\n\u003cp\u003eHospital stay (median [IQR]): 7 [6\u0026ndash;7] days\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;3. Postoperative Outcomes and Quality of Life\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClavien\u0026ndash;Dindo\u0026thinsp;\u0026ge;\u0026thinsp;II complications: 0.0%\u003c/p\u003e\n\u003cp\u003eAnastomotic leak: 5.6%\u003c/p\u003e\n\u003cp\u003ePostoperative ileus: 2.8%\u003c/p\u003e\n\u003cp\u003eReoperation: 5.6%\u003c/p\u003e\n\u003cp\u003e30-day readmission: 0.0%\u003c/p\u003e\n\u003cp\u003eEQ-5D (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD): 0.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.14\u003c/p\u003e\n\u003cp\u003eGIQLI (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD): 96.2\u0026thinsp;\u0026plusmn;\u0026thinsp;17.6\u003c/p\u003e\n\u003cp\u003eLARS (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD): 15.1\u0026thinsp;\u0026plusmn;\u0026thinsp;8.8\u003c/p\u003e\n\u003cp\u003ePain NRS (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD): 2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e\n\u003cp\u003eSatisfaction (median [IQR]): 3 [2\u0026ndash;4]\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Departement of surgery","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"diverticular disease, laparoscopic resection, quality of life, GIQLI, EQ-5D, LARS","lastPublishedDoi":"10.21203/rs.3.rs-7945193/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7945193/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eElective laparoscopic resection is an established treatment for recurrent or symptomatic diverticular disease. This study evaluated clinical outcomes and postoperative quality of life after elective colonic resection.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis single-center retrospective study included 36 patients who underwent surgery between August 2023 and August 2025 at the Mater Olbia Hospital. Clinical, intraoperative, and postoperative data were analyzed with a median follow-up of 24 months. Primary endpoints were morbidity and length of stay; secondary endpoints included conversion, anastomotic leak, and quality-of-life scores (EQ-5D, GIQLI, LARS).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eLaparoscopic surgery was performed in 86% of cases with a 13.9% conversion rate. Mean operative time was 95\u0026thinsp;\u0026plusmn;\u0026thinsp;29 minutes, blood loss 121\u0026thinsp;\u0026plusmn;\u0026thinsp;81 mL, and hospital stay 7 [6\u0026ndash;7] days. No major complications (Clavien\u0026ndash;Dindo\u0026thinsp;\u0026ge;\u0026thinsp;II) occurred. Laparoscopy was associated with shorter operative time, lower blood loss, and reduced hospital stay (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eElective laparoscopic resection for diverticular disease is safe, effective, and provides favorable postoperative quality of life with low morbidity.\u003c/p\u003e","manuscriptTitle":"Outcomes and Quality of Life After Elective Laparoscopic Resection for Diverticular Disease of the Colon","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-28 14:17:48","doi":"10.21203/rs.3.rs-7945193/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"14e45e4e-2963-4320-b4f9-25cb740537de","owner":[],"postedDate":"October 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":56857918,"name":"General Surgery"}],"tags":[],"updatedAt":"2025-10-28T14:17:48+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-28 14:17:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7945193","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7945193","identity":"rs-7945193","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}