A Population-based Analysis of the Clinical Course of Colonic Diverticulitis and its Evolving Management

Evidence has accrued to support change in the management of colonic diverticulitis. Advances in imaging and medical management suggest more patients may be managed non-operatively; while various new operative approaches have been proposed as an alternative to Hartmann's procedure when urgent surgery is necessary. Furthermore, published reports suggest the clinical course of the disease may be characteristically benign; suggesting interval elective colectomy may be unnecessary for the majority of patients, even those with known risk factors. Reports to date consist predominantly of institutional cohort studies with high loss to follow-up and failure to account for competing risks. To address the gaps in knowledge, we performed a population-based retrospective cohort study. The objectives of this study were to (a) evaluate temporal trends in the management of diverticulitis, and (b) characterize the clinical course of the disease following initial non-operative management. Results from this study will help to inform best practice recommendations.M.Sc