Impact of elective minimally invasive sigmoidectomy for diverticular disease on quality of life: a single-center study

The indication for elective sigmoidectomy after acute diverticulitis is shifting from prevention of complications to patient-centered outcomes. This study evaluated the impact of elective minimally invasive sigmoidectomy on quality of life (QoL) using a disease-specific tool and identified clinical factors associated with greater postoperative benefit. This was a retrospective analysis of a prospectively maintained database including patients who underwent elective minimally invasive sigmoidectomy for diverticular disease between June 2019 and February 2025. QoL was assessed preoperatively and six months postoperatively using the validated Diverticulitis Quality of Life (DvQoL) questionnaire. Primary outcomes includedthe change in DvQoL score (ΔDvQoL), the achievement of the minimal clinically important difference (MCID) and the patient acceptable symptom state (PASS). Ridge-penalized linear regression and Firth penalized logistic regression were used to identify predictors of QoL improvement. Ninety-two patients were analyzed(median age 63.5 years; 59.8% female). Median DvQoL scores significantly improved from 3.15 preoperatively to 0.55 at six months (p < 0.001). The MCID was achieved by 58.7% (n = 54), and the PASS was reached by 91.3% (n = 84). Multivariable analysis identified higher preoperative DvQoL score (β = 0.499, p < 0.001), older age (p = 0.042), and male sex (p = 0.018) as independent predictors of greater QoL improvement and MCID achievement. Surgical technique and disease severity (modified Hinchey classification) did not significantly influence QoL outcomes. Elective minimally invasive sigmoidectomy is associated witha significant and clinically meaningful short-term improvement in QoL, with preoperative symptom burden serving as the strongest predictor of benefit. However, due to the retrospective nature of the analysis and the lack of a conservative control group, these findings represent clinical associations rather than direct causality. The potential role of the DvQoL tool in shared decision-making and patient selection requires future validation in larger, multicenter prospective trials.Trial registration Approved by the local Institutional Ethics Committee (Protocol number: 6585 N/AO/26).