{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T17:26:08Z","timestamp":1769016368248,"version":"3.49.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T00:00:00Z","timestamp":1673827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T00:00:00Z","timestamp":1673827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Schleswig-Holstein - Campus L\u00fcbeck"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Sigmoid resection for diverticular disease is a frequent surgical procedure in the Western world. However, long-term bowel function after sigmoid resection has been poorly described in the literature. This study aims to assess the long-term bowel function after tubular sigmoid resection with preservation of inferior mesenteric artery (IMA) for diverticular disease.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrospectively identified patients who underwent sigmoid resection for diverticular disease between 2002 and 2012 at a tertiary referral center in northern Germany. Using well-validated questionnaires, bowel function was assessed for fecal urgency, incontinence, and obstructed defecation. The presence of bowel dysfunction was compared to baseline characteristics and perioperative outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Two hundred and thirty-eight patients with a mean age of 59.2\u2009\u00b1\u200910\u00a0years responded to our survey. The follow-up was conducted 117\u2009\u00b1\u200932\u00a0months after surgery. At follow-up, 44 patients (18.5%) had minor LARS (LARS 21\u201329) and 35 (15.1%) major LARS (LARS\u2009\u2265\u200930\u201342), 35 patients had moderate-severe incontinence (CCIS\u2009\u2265\u20097), and 2 patients (1%) had overt obstipation (CCOS\u2009\u2265\u200915). The multivariate analysis showed that female gender was the only prognostic factor for long-term incontinence (CCIS\u2009\u2265\u20097), and ASA score was the only preoperative prognostic factor for the presence of major LARS at follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Sigmoid resection for diverticular disease can be associated with long-term bowel dysfunction, even with tubular dissection and preservation of IMA. These findings suggest intercolonic mechanisms of developing symptoms of bowel dysfunction after disruption of the colorectal continuity that are so far summarized as \u201csigmoidectomy syndrome.\u201d\n<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00384-023-04311-1","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T12:03:03Z","timestamp":1673870583000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease"],"prefix":"10.1007","volume":"38","author":[{"given":"Thaer S. A.","family":"Abdalla","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Weisheit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Thomaschewski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Deichmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Nolde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Keck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Benecke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,1,16]]},"reference":[{"issue":"7","key":"4311_CR1","doi-asserted-by":"publisher","first-page":"1731","DOI":"10.1053\/j.gastro.2015.08.045","volume":"149","author":"AF Peery","year":"2015","unstructured":"Peery AF, Crockett SD, Barritt AS, Dellon ES, Eluri S, Gangarosa LM et al (2015) Burden of gastrointestinal, liver, and pancreatic diseases in the United States. Gastroenterology 149(7):1731\u201341.e3","journal-title":"Gastroenterology"},{"issue":"12","key":"4311_CR2","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1016\/j.cgh.2013.06.020","volume":"11","author":"K Shahedi","year":"2013","unstructured":"Shahedi K, Fuller G, Bolus R, Cohen E, Vu M, Shah R et al (2013) Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy. Clin Gastroenterol Hepatol 11(12):1609\u20131613","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"7","key":"4311_CR3","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1007\/s10350-006-0578-2","volume":"49","author":"J Rafferty","year":"2006","unstructured":"Rafferty J, Shellito P, Hyman NH, Buie WD (2006) Practice parameters for sigmoid diverticulitis. Dis Colon Rectum 49(7):939\u2013944","journal-title":"Dis Colon Rectum"},{"issue":"Suppl 2","key":"4311_CR4","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/codi.15140","volume":"22","author":"JK Schultz","year":"2020","unstructured":"Schultz JK, Azhar N, Binda GA, Barbara G, Biondo S, Boermeester MA et al (2020) European Society of Coloproctology: guidelines for the management of diverticular disease of the colon. Colorectal Disease 22(Suppl 2):5\u201328","journal-title":"Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland"},{"key":"4311_CR5","doi-asserted-by":"crossref","unstructured":"Schwenk W, Haase O, Neudecker J, M\u00fcller JM (2005) Short term benefits for laparoscopic colorectal resection. Cochrane database syst rev (3):Cd003145","DOI":"10.1002\/14651858.CD003145.pub2"},{"issue":"10","key":"4311_CR6","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1002\/bjs.1800571021","volume":"57","author":"TG Parks","year":"2005","unstructured":"Parks TG, Connell AM (2005) The outcome in 455 patients admitted for treatment of diverticular disease of the colon. Br J Surg 57(10):775\u2013778","journal-title":"Br J Surg"},{"issue":"9","key":"4311_CR7","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1002\/bjs.1800770927","volume":"77","author":"J Moreaux","year":"2005","unstructured":"Moreaux J, Vons C (2005) Elective resection for diverticular disease of the sigmoid colon. Br J Surg 77(9):1036\u20131038","journal-title":"Br J Surg"},{"issue":"3","key":"4311_CR8","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/BF02555016","volume":"29","author":"RE Breen","year":"1986","unstructured":"Breen RE, Corman ML, Robertson WG, Prager ED (1986) Are we really operating on diverticulitis? Dis Colon Rectum 29(3):174\u2013176","journal-title":"Dis Colon Rectum"},{"issue":"7","key":"4311_CR9","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1007\/s10350-008-9234-3","volume":"51","author":"B Egger","year":"2008","unstructured":"Egger B, Peter MK, Candinas D (2008) Persistent symptoms after elective sigmoid resection for diverticulitis. Dis Colon Rectum 51(7):1044\u20131048","journal-title":"Dis Colon Rectum"},{"issue":"1","key":"4311_CR10","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/BF02050307","volume":"36","author":"JM Jorge","year":"1993","unstructured":"Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36(1):77\u201397","journal-title":"Dis Colon Rectum"},{"issue":"5","key":"4311_CR11","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1097\/SLA.0b013e31824f1c21","volume":"255","author":"KJ Emmertsen","year":"2012","unstructured":"Emmertsen KJ, Laurberg S (2012) Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg 255(5):922\u2013928","journal-title":"Ann Surg"},{"issue":"6","key":"4311_CR12","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1007\/BF02056950","volume":"39","author":"F Agachan","year":"1996","unstructured":"Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD (1996) A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum 39(6):681\u2013685","journal-title":"Dis Colon Rectum"},{"issue":"1","key":"4311_CR13","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1097\/DCR.0b013e31823907a9","volume":"55","author":"MM Levack","year":"2012","unstructured":"Levack MM, Savitt LR, Berger DL, Shellito PC, Hodin RA, Rattner DW et al (2012) Sigmoidectomy syndrome? Patients\u2019 perspectives on the functional outcomes following surgery for diverticulitis. Dis Colon Rectum 55(1):10\u201317","journal-title":"Dis Colon Rectum"},{"key":"4311_CR14","doi-asserted-by":"crossref","unstructured":"Masoni L, Mari FS, Nigri G, Favi F, Gasparrini M, Dall\u2019Oglio A et al (2013) Preservation of the inferior mesenteric artery via laparoscopic sigmoid colectomy performed for diverticular disease: real benefit or technical challenge: a randomized controlled clinical trial. Surg Endosc 27(1):199\u2013206","DOI":"10.1007\/s00464-012-2420-3"},{"issue":"3","key":"4311_CR15","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1159\/000367625","volume":"90","author":"W Kruis","year":"2014","unstructured":"Kruis W, Germer CT, Leifeld L (2014) Diverticular disease: guidelines of the german society for gastroenterology, digestive and metabolic diseases and the german society for general and visceral surgery. Digestion 90(3):190\u2013207","journal-title":"Digestion"},{"key":"4311_CR16","doi-asserted-by":"crossref","unstructured":"Hansen O, Stock W (1999) Prophylaktische Operation bei der Divertikelkrankheit des Kolons\u2013Stufenkonzept durch exakte Stadieneinteilung. Langenbecks Arch Chir (Suppl II):1257","DOI":"10.1007\/978-3-642-60248-1_319"},{"issue":"2","key":"4311_CR17","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1111\/codi.15517","volume":"23","author":"P Christensen","year":"2021","unstructured":"Christensen P, Im Baeten C, Esp\u00edn-Basany E, Martellucci J, Nugent KP, Zerbib F et al (2021) Management guidelines for low anterior resection syndrome - the MANUEL project. Colorectal Dis 23(2):461\u2013475","journal-title":"Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland"},{"issue":"12","key":"4311_CR18","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1111\/j.1365-2982.2009.01331.x","volume":"21","author":"S Dobrowolski","year":"2009","unstructured":"Dobrowolski S, Ha\u0107 S, Kobiela J, Sledzi\u0144ski Z (2009) Should we preserve the inferior mesenteric artery during sigmoid colectomy? Neurogastroenterol Motil 21(12):1288-e123","journal-title":"Neurogastroenterol Motil"},{"issue":"5","key":"4311_CR19","doi-asserted-by":"publisher","first-page":"G508","DOI":"10.1152\/ajpgi.00021.2017","volume":"312","author":"AY Lin","year":"2017","unstructured":"Lin AY, Du P, Dinning PG, Arkwright JW, Kamp JP, Cheng LK et al (2017) High-resolution anatomic correlation of cyclic motor patterns in the human colon: evidence of a rectosigmoid brake. Am J Physiol Gastrointest Liver Physiol 312(5):G508-g15","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"issue":"2","key":"4311_CR20","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1111\/codi.15465","volume":"23","author":"C Keane","year":"2021","unstructured":"Keane C, Paskaranandavadivel N, Vather R, Rowbotham D, Arkwright J, Dinning P et al (2021) Altered colonic motility is associated with low anterior resection syndrome. Colorectal disease\u202f: the official journal of the Association of Coloproctology of Great Britain and Ireland 23(2):415\u201323","journal-title":"Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland"},{"issue":"5","key":"4311_CR21","doi-asserted-by":"publisher","first-page":"1571","DOI":"10.1007\/s00423-021-02186-w","volume":"406","author":"A Posabella","year":"2021","unstructured":"Posabella A, Steinemann DC, Droeser RA, Varathan N, Ay\u00e7i\u00e7ek SG, Nocera F et al (2021) Predictive model estimating the decrease of postoperative gastrointestinal quality of life index (GIQLI) in patients after elective laparoscopic sigmoid resection for diverticular disease. Langenbecks Arch Surg 406(5):1571\u201380","journal-title":"Langenbecks Arch Surg"}],"container-title":["International Journal of Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-023-04311-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00384-023-04311-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-023-04311-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T11:06:46Z","timestamp":1703156806000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00384-023-04311-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,16]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["4311"],"URL":"https:\/\/doi.org\/10.1007\/s00384-023-04311-1","relation":{},"ISSN":["1432-1262"],"issn-type":[{"value":"1432-1262","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,16]]},"assertion":[{"value":"8 January 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the institutional review board and ethics committee at the University of L\u00fcbeck (AZ 15\u2013302).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Patient consent was waived due to the analysis of anonymized data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"14"}}