Primary Anastomosis with Diverting Loop Ileostomy in Acute Complicated Diverticulitis

A study of 16,921 cases of nonelective sigmoidectomy for acute complicated diverticulitis revealed a rising trend in the use of primary anastomosis with diverting loop ileostomy, from 5.3% in 2012 to 8.4% in 2020. Compared to Hartmann’s procedure, primary anastomosis with diverting loop ileostomy was associated with lower rates of major adverse events (24.6% vs 29.3%), and reduced risks of respiratory and infectious complications. However, it showed longer operative times and increased odds of 30-day readmission. These findings suggest a shift in surgical approach towards primary anastomosis in the management of acute complicated diverticulitis.