{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:43:43Z","timestamp":1787244223502,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Growing evidence suggests that immune\/inflammatory pathways play a crucial role in the persistence of symptoms in diverticular disease (DD). We hypothesize that chronic diverticulitis triggers a self\u2010sustained inflammatory status which can be detected by measuring the levels of tumor necrosis factor\u2010\u03b1 (TNF\u2010\u03b1) and interleukin\u20106 (IL\u20106). The aim of this study was to investigate the systemic levels of TNF\u2010\u03b1 and IL\u20106 before and after elective surgery in patients with DD, and their relationship with the gastrointestinal quality of life index (GIQLI) score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This prospective multicentric study enrolled patients from the Diverticular Disease Registry (DDR\u2010Trial, NCT04907383). All adult patients diagnosed with symptomatic uncomplicated diverticular disease (SUDD), uncomplicated recurrent diverticulitis (URD) and smouldering diverticulitis (SmD) between 1st December 2022 and 31st December 2023 were included in this study. Exclusion criteria were as follows: no surgery, a concurrent chronic immunomodulated systemic disease, a SARS\u2010CoV\u20102\u2010positive test in the previous 12\u2009months, a history of cancer in the previous 5\u2009years, patients treated with immunomodulators, an American Society of Anesthesiologists category of class IV, and complicated acute diverticulitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010two patients were included: 52 (72%) with URD, 11 (15%) with SUDD, and nine (13%) with SmD. The median postsurgery\u2009\u2013\u2009presurgery (\u0394)IL\u20106 and \u0394TNF\u2010\u03b1 levels were \u221216.8 and \u221217.3\u2009pg\/mL, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for both; Wilcoxon test). Spearman correlation revealed a significant, negative association between the \u0394GIQLI and the \u0394IL\u20106, as well as the \u0394TNF\u2010\u03b1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for both). Greater reduction in the levels of IL\u20106 and TNF\u2010\u03b1 following surgery are associated with higher GIQLI scores postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with chronic diverticulitis may experience persistent systemic inflammation driven by a colonic trigger. Surgical removal of this trigger appears to enhance GIQLI outcomes reducing IL\u20106 and TNF\u2010\u03b1 across surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70132","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T01:12:36Z","timestamp":1749517956000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of elective surgery on tumor necrosis factor\u2010\u03b1, interleukin\u20106 and quality of life in uncomplicated diverticular disease"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7649-4703","authenticated-orcid":false,"given":"Richard","family":"Sassun","sequence":"first","affiliation":[{"name":"General Surgery Residency Program University of Milan  Milan Italy"},{"name":"General Surgery Unit Pio XI Hospital, ASST Brianza  Desio, Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Roufael","sequence":"additional","affiliation":[{"name":"General Surgery Residency Program University of Milan  Milan Italy"},{"name":"General Surgery Unit Pio XI Hospital, ASST Brianza  Desio, Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4090-0989","authenticated-orcid":false,"given":"Jacopo","family":"Crippa","sequence":"additional","affiliation":[{"name":"General Surgery Unit Vizzolo\u2010Predabissi, ASST Melegnano Martesana  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Magistro","sequence":"additional","affiliation":[{"name":"General Surgery Unit Vizzolo\u2010Predabissi, ASST Melegnano Martesana  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camillo","family":"Bertoglio","sequence":"additional","affiliation":[{"name":"General Surgery Unit ASST Ovest Milanese  Magenta, Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9021-9521","authenticated-orcid":false,"given":"Pietro","family":"Achilli","sequence":"additional","affiliation":[{"name":"Department of Mini\u2010Invasive Surgery ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenza Paola","family":"Dinuzzi","sequence":"additional","affiliation":[{"name":"General Surgery Unit ASST Ovest Milanese  Magenta, Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isacco","family":"Montroni","sequence":"additional","affiliation":[{"name":"General Surgery Unit Ospedale Santa Maria Delle Croci  Ravenna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Maggioni","sequence":"additional","affiliation":[{"name":"General Surgery Unit Pio XI Hospital, ASST Brianza  Desio, Monza 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Leoni","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pathology and Toxicology Hospital Pio XI of Desio, ASST\u2010Brianza  Desio MB Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Wesley","family":"Larson","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Mari","sequence":"additional","affiliation":[{"name":"General Surgery Unit Pio XI Hospital, ASST Brianza  Desio, Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Advanced International Mini\u2010invasive Surgery Academy Clinical Research 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