Evolving Approaches in Left-Sided Colonic Diverticulitis Management- A Systematic narrative Review of Surgical and Non-Operative Strategies

Abstract Colonic diverticulitis is a common disease affecting the colon and can lead to significant complications. This review compares surgical and non-surgical treatment options for left-sided diverticulitis. Following the Joanna Briggs Institute (JBI) guidelines and PRISMA standards, a systematic narrative review was conducted. Literature from 2015 to 2026 was systematically searched in PubMed, Google Scholar, Embase, Scopus, Web of Science, and CINAHL databases using the PICO framework, focusing on adult patients aged 18 and above with left-sided diverticulitis and outcomes related to laparoscopic surgery, Hartmann's procedure, primary anastomosis, and conservative management. Fourteen studies met the inclusion criteria and were critically appraised by the JBI. Data were organized by theme and analyzed for recurrence, complications, quality of life, hospitalization, and pain management efficacy. The review indicates a preference for minimally invasive, personalized treatments that lead to better outcomes. Benefits of laparoscopic approaches include less pain, quicker recovery, improved quality of life, and lower stoma rates. When suitable patients were selected, the primary anastomosis group showed better functional outcomes compared to the Hartmann's procedure group. Overall, individualized treatment approaches are associated with safer, more effective long-term management of diverticulitis.