To Scope or not to Scope; Value of Routine Colonoscopy after Uncomplicated Diverticulitis in Switzerland. A Retrospective Cohort Study

Abstract

Abstract Purpose Diverticular disease is common in the western world. Due to the risk of undetected underlying colorectal cancer, most guidelines recommend a follow-up colonoscopy after an episode of diverticulitis. With the increased accuracy of computer tomography scans, there is an increased challenge to these guidelines in cases of uncomplicated diverticulitis. The aim of this study was to investigate the compliance to the recommended follow-up colonoscopies and to report the incidence of detection of advanced neoplasms. Methods In this single-center retrospective cohort study, all patients > 18 years that were admitted to the Hospital Center Biel with an episode of acute uncomplicated diverticulitis between 01.01.2013 and 31.12.2017 were identified. The incidence of advanced neoplasia was calculated by analyzing the follow-up colonoscopies performed and reviewing the histological findings. Results 257 Patients with uncomplicated diverticulitis were included in this study. The mean age of the patients was 63 (range 22–96) years, and 54.5% were female. In 197 (77%) patients we recommended a follow-up colonoscopy. However, only 144 (73%) of these patients underwent the procedure. In the histological analysis, 2 (1.2%) carcinomas, one high-grade adenoma (0.6%) and 20 low-grade adenomas (12%) were detected. Conclusion The compliance to the recommendation of follow-up colonoscopies after uncomplicated diverticulitis is poor and has to be improved. A follow-up colonoscopy has its justification because of relevant findings in almost 14% of patients, more so in patients above screening age with 20% pathological findings, including 2 (5%) carcinomas.