Reoperative surgery for diverticular disease and its complications

The need for reoperation for diverticulitis may become necessary for a range of conditions. Surgeons will most commonly encounter these conditions in an elective setting with planned cases for ostomy reversal, however, recurrence of acute disease after sigmoid resection also occurs with a degree of regularity. A suspected recurrence should prompt a workup for alternative conditions, such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Reoperation in the emergent setting may be necessary for both recurrent diverticulitis as well as complications from earlier procedures. Attention to technical details improves outcome of both elective and emergent reoperations. The operative plan should be individualized to optimize patient outcomes. This discussion will review necessary details to enhance the chance of successful outcomes. Details for the management of some of these issues (problems common to colon and rectal surgery in general, e.g., anastomotic leaks, stoma complications, and fistulas) are discussed elsewhere in this publication. Some conclusions are based on the extrapolation of data from more generalized reviews because the literature on reoperative diverticular surgery is limited.