Surgery is reserved for recurrent episodes, complications or severe attacks of diverticulitis, or when there is no response to medical treatment. Surgery in the form of a one- or two-stage operation is considered to be a safe and reliable option. Hartmann's (1923) procedure is a two-stage operation; in diverticular disease it is usually performed in an emergency for perforation and faecal peritonitis of a diverticular abscess or obstruction. The one-stage primary anastomosis is proving to be a viable option (Belmonte et al., 1996; Regenet et al., 2003; Zorcolo et al., 2003).
Elective surgery is performed for recurrent episodes of diverticulitis, complications or severe attacks. However, there is a trend to perform surgery as an elective procedure, especially in the younger patient, and in some cases laparoscopically (Bruce et al., 1996). Surgical treatment is usually necessary in 20-30% of patients with acute diverticulitis.
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