Elective surgery for diverticular disease in U.S. veterans: A VASQIP study of national trends and outcomes from 2004 to 2018

Document Type

Journal Article

Publication Date

1-1-2020

Journal

American Journal of Surgery

DOI

10.1016/j.amjsurg.2020.08.050

Keywords

30-Day morbidity; Diverticular disease; Elective colectomy; VASQIP; Veterans affairs

Abstract

© 2020 Background: Treatment for diverticular disease has evolved over time. In the United States, there has been a trend towards minimally invasive surgical approaches and fewer postoperative complications, but no study has investigated this subject in the Veterans Health Administration. Methods: This retrospective review identified patients undergoing elective surgery for diverticular disease from 2004 to 2018. Demographics, comorbidities, operative approach, rates of ostomy creation, and 30-day outcomes were compared. The 15-year time period was divided into 3-year increments to assess changes over time. Results: 4198 patients were identified. Complication rate decreased significantly over time (28.1%–15.7%, p < 0.001), as did infectious complications (21.5–6.3%, p < 0.001). Median hospital length-of-stay decreased from 7 to 5 days (p < 0.001). Rates of laparoscopic surgery increased over time (17.7%–48.1%, p < 0.001). Conclusions: Increased utilization of laparoscopy in veterans undergoing elective surgery for diverticular disease coincided with fewer complications and a shorter length-of-stay. These trends mirror outcomes reported in non-veterans.

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