[Smoldering diverticultis - still a type of chronic recurrent diverticulitis with good indication for surgery? - Surgery for smoldering diverticulitis]. / Smoldering-Divertikulitis ­ doch eine Form der chronisch-rezidivierenden Divertikulitis mit guter Operationsindikation?

BACKGROUND: Elective surgery for recurrent uncomplicated diverticulitis is a matter of debate. "Smoldering diverticulitis" (SmD) describes a subtype of the disease which is characterized by frequently relapsing symptoms triggered by a "smoldering fire-like" ongoing inflammatory process. The aim of this study was to investigate the value of surgery in these patients. METHODS: Forty-four patients with the clinical signs of SmD were selected from a prospective database of 393 patients with elective surgery for diverticulitis. They were compared for morbidity and the effect of surgery on quality of life (QL) (Gastrointestinal QL-Index (GLQI)) with a group of 95 patients who had elective surgery for perforated diverticulitis. RESULTS: Morbidity was equivalent in both groups with shorter durations of surgery in the SmD group (159 (65-301) vs. 174 (100-443) minutes, p = 0.031). Six months after surgery, a significant improvement of QL was found in the SmD group (GLQI 115 (72-143) vs. 98 (56-139) preoperatively, p = 0.018). In the control groups, only a non-significant improvement of the preoperatively less suppressed quality of life was noted. Approximately 80 % of the patients were satisfied with the outcome of surgery. CONCLUSION: In patients with SmD like chronic recurrent disease surgery is effective to improve quality of life.