Operative management of colonic diverticular disease in the setting of immunosuppression: A systematic review and meta-analysis

Abstract Background Immunosuppressed patients with diverticular disease are at higher risk of postoperative complications, however reported rates have varied. The aim of this study is to compare postoperative outcomes in immunosuppressed and immunocompetent patients undergoing surgery for diverticular disease. Methods Medline, EMBASE, and CENTRAL were searched. Articles were included if they compared immunosuppressed and immunocompetent patients undergoing surgery for diverticular disease. Results From 204 citations, 11 studies with 2977 immunosuppressed patients and 780,630 immunocompetent patients were included. Mortality was greater in immunosuppressed patients compared to immunocompetent patients for emergent surgery (RR 1.91, 95%CI 1.24–2.95, p  Conclusions Increased consideration for elective operation may preclude the need for emergent surgery and the associated increase in postoperative mortality.