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Session:: ePosters-Sun130-M8: Benign Abdominal

EP521 - Elective surgery for diverticulitis in immunosuppressed patients: does the risk really increase? A propensity-weighted cohort study of 4,473 patients

Sunday, May 10, 2026
1:40 PM - 1:45 PM ET
Purpose/Background: Diverticulitis is a common condition that can affect patients receiving immunosuppressive therapy. Management of these patients remains controversial. The aim of this study was to evaluate the outcomes of elective surgery for diverticulitis in immunosuppressed patients and to compare them to those of immunocompetent patients.

Methods/Interventions: All consecutive patients who underwent elective surgery for diverticulitis from January 2010 to December 2021 were included in this retrospective, multicenter, cohort study. Two groups of patients were defined: patients who were under immunusuppressors (IS+ group) and patients who were not under immunosuppressors (IS- group). The primary endpoint was the rate of severe complications within 90 days after surgery according to the Clavien-Dindo scale (Clavien-Dindo III-V). The secondary endpoints were the overall morbidity rate, the anastomotic leak rate, the mortality rate, and the risk of readmission. We used a propensity score analysis.

Results/Outcomes: 4473 patients who underwent elective surgery for diverticulitis were included, 386 (8.6%) were under immunosupressors (IS+ group) and 4057 (91,4%) were not under immunosupressors (IS- group). After adjustment on the propensity score, the rate of severe morbidity (OR: 0.93, CI95% [0.65-1.33], p=0.7), the overall morbidity rate (OR= 0.98; CI95% [0.76-1.26], p=0.8), the mortality rate (OR= 2.06; CI95% [0.75-5.64], p=0.1), the anastomotic leak rate (OR= 1.11; CI95% [0.6-2.04], p=0.7), and the risk of readmission (OR= 1.06; CI95% [0.73-1.53], p=0.7) were not different. The morbidity and mortality rate were linked to the ASA score.

Conclusion/Discussion: In conclusion, immunosuppressive therapy alone does not appear to be an independent risk factor for postoperative morbidity. The ASA classification and comorbidities remain the primary determinants of surgical risk in patients undergoing elective surgery for diverticulitis.