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The symptoms of stricturing diverticulitis can overlap with those of colorectal cancer. Additionally, the stricture itself may mask a "hidden" colorectal cancer. We aimed to describe the demographics, operative details and outcomes, including occult colorectal cancer, in a cohort of consecutive resections for presumed diverticular strictures. In this single-center, retrospective cohort study, all patients undergoing resection for a presumed diverticular stricture between January 2010 and December 2015 were included. Preoperative imaging and colonoscopies were individually reviewed. Only patients with radiographically, endoscopically and/or intraoperatively benign-appearing strictures were included. One hundred fifty patients (72.7% female, mean age = 70.4 ± 11.8 years, 62.7% elective) were included. Only 34 (22.7%) had a complete preoperative colonoscopy. In 95 (63.6% of cohort) patients, the stricture was non-traversable colonoscopically. Overall, 47 (31.3%) patients did not have complete preoperative imaging or a colonoscopy. In total, 53.3% were open procedures and 62% had non-diverted primary anastomosis. Eleven (14.7%) underwent resection of adjacent organs (5 appendixes/5 right colons/7 fallopian tubes ± ovaries/3 small bowel resections/2 partial cystectomies/1 spleen). The median length of stay was 7 (5, 12.5) days. Only 2 cancers (1.3% of patients) involving the stricture (1 invasive moderately differentiated sigmoid adenocarcinoma/1 lymphoma) were found. Three additional cancers were found in organs involved in the inflammatory process (20% of concomitantly resected organs, 1 ovarian carcinoma/1 leukemia in a lymph node/1 appendiceal tumor). Despite approximately one-third of the cohort not having undergone successful preoperative colonoscopy or imaging, the rate of neoplasia involving diverticular strictures was only 1.3%. A relatively high cancer rate was found in concomitantly resected organs involved in the stricturing process. [ABSTRACT FROM AUTHOR]

Idiopathic myointimal hyperplasia of the mesenteric veins is an extremely rare non-thrombotic mesenteric veno-occlusive disease. The management of idiopathic myointimal hyperplasia of the mesenteric veins is not well-established, and although surgery is the mainstay of treatment, the optimal operation remains unclear. Therefore, we aimed to perform a systematic review to assess the various surgical procedures and associated outcomes for patients with idiopathic myointimal hyperplasia of the mesenteric veins. A systematic search for articles published from 1946 to April 2022 in MEDLINE, EMBASE, Cinahl, Scopus, Web of Science, and Cochrane Library databases is reported. In addition, we report 4 cases of idiopathic myointimal hyperplasia of the mesenteric veins managed at our institution until March 2023. A total of 53 studies and 88 patients with idiopathic myointimal hyperplasia of the mesenteric veins were included. Most (82%) were male patients, with a mean age of 56.6 years old. The majority (99%) of patients required surgery. Most reports described the involvement of the rectum and sigmoid colon (81%). The most common surgical procedures were Hartmann's procedure (24%) and segmental colectomy (19%); completion proctectomy with ileal pouch-anal anastomosis was performed in 3 (3.4%) cases. In 6 (6.8%) cases, idiopathic myointimal hyperplasia of the mesenteric veins was suspected preoperatively and managed with elective surgery. Four (4.5%) complications were reported. Nearly all (99%) patients achieved remission with surgical intervention. Idiopathic myointimal hyperplasia of the mesenteric veins is a rare pathologic entity infrequently suspected preoperatively and typically diagnosed after surgical resection. Surgical resection with Hartmann's procedure or segmental colectomy was most commonly performed, with completion proctectomy and ileal pouch-anal anastomosis reserved for cases of extensive rectal involvement. Surgical resection was safe and effective, with a low risk of complications and recurrence. Surgical decision-making should be based on the extent of the disease at the time of presentation. [ABSTRACT FROM AUTHOR]

Patients commonly use the internet to obtain medical information. Patients in our outpatient setting frequently have incomplete or even incorrect information about hyperthermic intraperitoneal chemotherapy that they have found on the internet. We aimed to assess the quality and content of Web-based information on hyperthermic intraperitoneal chemotherapy using validated and novel scoring systems. The keywords "HIPEC" and "hyperthermic intraperitoneal chemotherapy" were entered into the most commonly used internet search engines (Google, Bing, and Yahoo). The first 10 websites from each search were analyzed. Website quality was assessed using the validated Journal of the American Medical Association benchmark criteria and DISCERN scoring systems. We created a novel hyperthermic intraperitoneal chemotherapy–specific score with surgeon experts in the field. Eighteen unique websites were identified. The majority (78%) were from academic institutions. The mean total DISCERN score for all websites was 41.8 ± 8.4 (maximum possible points = 75). The mean Journal of the American Medical Association and hyperthermic intraperitoneal chemotherapy–specific scores were 1.72 ± 1.13 (maximum possible score = 4) and 11.5 ± 4.5 (maximum possible score = 31), respectively. The lowest Journal of the American Medical Association scores were in the category of authorship. In total, 78% of websites omitted author details; 83% and 78% included the temperature and duration of hyperthermic intraperitoneal chemotherapy, respectively. Only 39% of websites mentioned complications of hyperthermic intraperitoneal chemotherapy. Web-based information on hyperthermic intraperitoneal chemotherapy is of variable content and quality. None of the websites achieved maximum scores using any of the scoring tools. Less than half of the websites provided any information on possible complications of the procedure. These findings should be highlighted to patients using the internet to obtain information about hyperthermic intraperitoneal chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Ulcerative colitis (UC) is a chronic mucosal inflammatory bowel disease of the colon and rectum. After 10 years of having the disease, there is a significant risk of dysplasia or cancer in the affected colon and rectum, and because of the often aggressive biology of these tumors, frequent endoscopic surveillance is warranted. Over a third of patients with UC will ultimately require an operation, and although for specific cases alternative operations can be pursued, most patients prefer an ileal pouch-anal anastomosis (IPAA) with J-pouch construction. Case: A staged IPAA removes the affected colon and rectum treating UC and also restores intestinal continuity. However, the standard colectomy for UC includes low ligations of the main colonic vascular pedicle branches (ileocolic, right colic, middle colic and inferior mesenteric) that does not address a proper oncologic operation. A high ligation of the named vessels as well as a proper resection of the affected colon with its mesentery and lymph node package are needed to treat colon cancer. Analogous to a total mesorectal exicision for rectal cancer, a more radical procedure to remove the tumor and lymph node packet for colon cancer is described as a complete mesocolic exision (CME) in efforts to increase disease free survival. Discussion: We demonstrate a laparoscopic subtotal colectomy for UC, with an oncologic complete mesocolic excision for a left transverse colon carcinoma in the setting of chronic mucosal inflammation secondary to chronic UC as the first procedure in a 3-staged IPAA. In the video, it is also demonstrated how the lymph node dissection is extended towards the greater gastric curvature and comprising omentum and gastrocolic ligament. There were no postoperative complications in the 44-year old male patient. [ABSTRACT FROM AUTHOR]

Purpose: The shift in the national focus and allocation of resources to the management of COVID19 has led to significant changes to surgical practice including the delay of elective surgery. The aim of this study was to explore the implications of such changes on surgeons.Method: Using a qualitative study design, semi-structured interviews were conducted with general surgery consultants and non-consultant hospital doctors from a major tertiary hospital in the Dublin region between March-May 2020. Data collection proceeded iteratively using a thematic analysis approach with quality controls such as memoing and collaborative analysis.Results: Fourteen surgeons (8 male, 6 female) were interviewed. The majority (n = 11, 78.6%) were NCHDs. Significant themes determined included 'impacts' on a variety of constructs such as performance, self-reported fatigue and wellbeing. Training themes elucidated included the effects of the cancellation of elective admissions on reduced operative exposure for trainees. Senior surgical staff were particularly focused on increased complexity in patient management. New policy requirements such as personal protective equipment use and novel rotas have had implications for aspects of work engagement. The pandemic and subsequent national restrictions imposed has afforded opportunities for improved well-being but also resulted in greater solitude in surgeons.Conclusions: Rhetoric surrounding fatigue management and virus control dominates the conversation on the relationship between COVID-19 and surgery. Tipping the balance back to parity of fatigue management with service delivery in surgery will be key for sustainability of the surgical workforce. [ABSTRACT FROM AUTHOR]

Aim: Although commonly the first port of call for medical information, the internet provides unregulated information of variable quality. We aimed to evaluate commonly accessed web-based patient information on diverticulitis using validated and novel scoring systems.Methods: The top internet search engines (Google/Bing/Yahoo) were queried using the keyword 'diverticulitis.' The first 20 websites from each were graded using the DISCERN and Journal of the American Medical Association (JAMA) benchmark criteria. A novel diverticulitis-specific score was devised and applied.Results: Thirty-six unique websites were identified. The mean total DISCERN score for all websites was 39.92 ± 12.44 (range = 18-62). No website achieved the maximum DISCERN score of 75. The mean JAMA and diverticulitis scores were 2.5 ± 1.08 (maximum possible score = 4) and 11.08 ± 4.17 (19 points possible) respectively. Fourteen (35.9%) and 20 (51.2%) did not provide the date of last update and authorship respectively. Thirty-three (84.6%) mentioned surgery as a treatment option; however, the majority (69.7%) did not describe the surgery or the possibility of a stoma. All except two described disease symptoms. Only ten (25.64%) provided information on when to seek further medical advice or help.Conclusion: Web-based information on diverticulitis is of variable content and quality. The majority of top websites describe disease symptoms and aetiology; however, information to prompt seeking medical attention if required, descriptions of surgical procedures and the possibility of stoma creation are poorly described in the majority of websites. These findings should be highlighted to patients utilising the internet to obtain information on diverticulitis. [ABSTRACT FROM AUTHOR]

Purpose: Bibliometric analysis highlights the key topics and studies which have led to the current understanding and treatment of a disease of interest. In this original article we analyze the 100 most cited manuscripts in the field of colorectal cancer (CRC).Materials and Methods: The Thomson Reuters Web of Science database with the search terms 'colorectal cancer,' 'colorectal cancer surgery,' 'colon cancer,' 'rectal cancer,' 'colorectal carcinoma,' 'colon carcinoma,' 'rectal carcinoma' and/or 'colonoscopy' was used to identify the manuscripts for the study. Only full length manuscripts were included. The 100 most cited papers were identified and further analyzed by topic, journal, author, year and institution. The journals' 5 year impact factor and Eigenfactor scores were recorded.Results: 146,833 eligible papers were returned. Within the top 100 cited manuscripts, the most studied topic was genetics in CRC (n = 41), followed by chemotherapy (n = 20) and surgical management (n = 7). The most cited paper authored by Fearon et al. (7850 citations) focused on genetic models of tumorgenesis. The NEJM published the highest number of papers (n = 23 with 42,576 citations). The country and year with the greatest number of publications were the USA (n = 62) and 2004 (n = 13) respectively.Conclusion: The most cited manuscripts highlighted in the current work describe the genetic, immunologic, basic science and surgical techniques that have resulted in the current understanding and treatment of CRC. The majority of these works were published in high impact journals and have been cited at least 900 times each reflecting their quality and influence. This work provides a reference of what could be considered as the most influential papers in CRC and serves as a reference for researchers and clinicians as to what makes a 'citable' paper. [ABSTRACT FROM AUTHOR]

We investigated and quantified defecation rates of crude oil by 3 species of marine planktonic copepods ( Temora turbinata , Acartia tonsa , and Parvocalanus crassirostris ) and a natural copepod assemblage after exposure to mechanically or chemically dispersed crude oil. Between 88 and 100% of the analyzed fecal pellets from three species of copepods and a natural copepod assemblage exposed for 48 h to physically or chemically dispersed light crude oil contained crude oil droplets. Crude oil droplets inside fecal pellets were smaller (median diameter: 2.4–3.5 μm) than droplets in the physically and chemically dispersed oil emulsions (median diameter: 6.6 and 8.0 μm, respectively). This suggests that copepods can reject large crude oil droplets or that crude oil droplets are broken into smaller oil droplets before or during ingestion. Depending on the species and experimental treatments, crude oil defecation rates ranged from 5.3 to 245 ng-oil copepod −1 d −1 , which represent a mean weight-specific defecation rate of 0.026 μg-oil μg-C copepod 1 d −1 . Considering a dispersed crude oil concentration commonly found in the water column after oil spills (1 μl L −1 ) and copepod abundances in high productive coastal areas, copepods may defecate ∼1.3–2.6 mg-oil m −3 d −1 , which would represent ∼0.15%–0.30% of the total dispersed oil per day. Our results indicate that ingestion and subsequent defecation of crude oil by planktonic copepods has a small influence on the overall mass of oil spills in the short term, but may be quantitatively important in the flux of oil from surface water to sediments and in the transfer of low-solubility, toxic petroleum hydrocarbons into food webs after crude oil spills in the sea. [ABSTRACT FROM AUTHOR]

Introduction A diverting stoma is often performed at the time of low anterior resection (LAR) for rectal cancer after neoadjuvant chemoradiation (nCRT) to protect the anastomosis. The aim of this study was to compare surgical outcomes in large cohorts of mid-high rectal cancer patients undergoing LAR after nCRT with and without a diverting stoma. Methods Patients undergoing LAR for rectal cancer (ICD-9 diagnosis code 154.1) after nCRT were identified from the American College of Surgeons National Surgical Quality Improvement Program database records from 2005 to 2012. Using Current Procedural Terminology (CPT) codes for LAR for mid-high rectal tumors, patients were stratified into diverting stoma (CPT: 44146, 44208) or no diverting stoma (CPT: 44145, 44207) cohorts. Emergency resection, stage IV disease, and permanent end colostomy patients were excluded. Results We included 1,406 patients in the analysis. All patients received nCRT; 607 (43%) received a diverting stoma and 799 (57%) were not diverted. The diverted group was more likely to have a higher body mass index (28.3 vs 27.4 kg/m 2 ; P = .02) and hypertension (46% vs 39%; P = .002). Otherwise, the group demographics and comorbidities were comparable. Overall morbidity was 28% for the entire cohort with no differences in deep organ space infection, sepsis and septic shock, unplanned reoperation, duration of stay, or overall mortality between the groups. Conclusion Diverting stoma does not decrease mortality or infectious complications in mid-high rectal cancer patients undergoing LAR after nCRT. The decision to construct a protective stoma should not be driven solely on the receipt of nCRT. [ABSTRACT FROM AUTHOR]

BACKGROUND: Organ space infection (OSI) rates post ileocolectomy for Crohn's disease are relatively high. The aim of this study was to determine which factors predispose to OSI in this patient cohort. METHODS: Data for 2,618 Crohn's patients undergoing ileocolectomy between 2005 and 2011 were obtained from the American College of Surgeons National Surgical Quality Improvement Project database. Primary outcome was an OSI within 30 days of discharge. Univariate analysis using chi-square and Student t tests and a logistic multivariate analysis were performed. RESULTS: Preoperative weight loss (odds ratio [OR] 2.11, P = .002), extended operating time (OR 1.57, P 5 .016), open procedures (OR 1.47, P = .043), and contaminated/dirty wounds (OR 1.95, P = .008) conferred an increased risk for OSI on multivariate analysis. Rates of stoma creation and steroid use were not significantly different between the groups CONCLUSIONS: Weight loss is a preoperative, potentially modifiable variable associated with OSI in Crohn's patients undergoing ileocolectomy and OSI-associated operative factors which may be noted to identify high-risk patients include extended operating time and open procedures [ABSTRACT FROM AUTHOR]

Background Clinical studies have suggested that patients with inflammatory bowel disease (IBD) are at greater risk for developing Clostridium difficile infection (CDI). The purpose of this study was to identify single-nucleotide polymorphisms (SNPs) associated with CDI among IBD patients. Methods This retrospective cohort study used our biobank to compare patients with IBD who developed CDI (IBD-CDI) with those who had never contracted CDI (IBD-nCDI). Patients were genotyped for 384 IBD-associated SNPs by microarray. Student t , chi-square, and Fisher exact tests were used. Multivariate logistic regression with Bonferroni correction was used for genotype analysis. Results Twenty IBD-CDI (14 with Crohn disease; 6 with ulcerative colitis) and 152 IBD-nCDI (47 CD/105 UC) patients were identified. The interleukin-4−associated SNP rs2243250 was associated with the development of CDI (raw P = .00005/corrected P = .02), with 15 of 20 (75%) CDI-IBD patients harboring the at-risk “A” allele versus 52 of 152 (34%) of IBD-nCDI. When we compared Crohn disease and ulcerative colitis patients separately, rs2243250 initially was associated with CDI in both groups, although clinical relevance was lost after Bonferroni correction. Conclusion The interleukin-4 gene−associated SNP rs2243250 was strongly associated with CDI in our IBD population. This SNP may allow for the identification of IBD patients at greater risk for CDI. [ABSTRACT FROM AUTHOR]

Overall, there were less patients in the hospital in general as patients due to the reduction in elective surgical procedures (including orthopaedic, gynaecologic and urology procedures) and a public fear of contracting COVID-19 in hospital. Keywords: COVID-19; SARS-CoV-2; Emergency surgery; General surgery; Coronavirus EN COVID-19 SARS-CoV-2 Emergency surgery General surgery Coronavirus e40 e41 2 03/10/21 20210401 NES 210401 To the Editor, As the country slowly returns to normal activity, we reflect on the effects of the COVID-19 global pandemic on surgical activity. COVID-19, SARS-CoV-2, Emergency surgery, General surgery, Coronavirus. [Extracted from the article]

Background Neoplasia complicating ulcerative colitis (UC-neoplasia) is a problem that is poorly addressed by present surveillance techniques. The association of greater than 300 single nucleotide polymorphisms (SNPs) with inflammatory bowel disease (IBD) suggests the possibility that certain genetic polymorphisms might identify patients with UC destined for malignant degeneration. This present study tested the hypothesis that presently known IBD-associated SNPs may correlate with UC-neoplasia. Materials and methods A total of 41 patients with UC-neoplasia (mean age 56 ± 2.1 years) were identified from our divisional IBD Biobank (low-grade dysplasia n = 13, high-grade dysplasia n = 8, colorectal cancer [CRC] n = 20). These patients were individually age, sex, and disease duration matched with UC patients without neoplasia. Primary sclerosing cholangitis and family history of CRC were recorded. Patients were genotyped for 314 of the most commonly IBD-associated SNPs by a custom SNP microarray. Logistic regression and Fischer exact test were used for statistical analysis. Results After Bonferroni correction, none of the 314 IBD-associated SNPs correlated with UC-neoplasia when compared with matched UC controls. The incidence of primary sclerosing cholangitis was greater in the UC-neoplasia group (10/41, 24% vs 3/41, 7%; P = .03) compared with UC controls. The severity of neoplasia (low grade dysplasia versus high grade dysplasia versus CRC) correlated with disease duration (7.9 vs 13.4 vs 20.7 years, respectively). Conclusion The lack of correlation between well-known IBD-associated SNPs and UC-neoplasia demonstrated in this study suggests that the development of neoplasia in patients with UC is associated with genetic determinants other than those that predispose to inflammation or results from posttranslational modifications or epigenetic factors rather than germline polymorphisms. [ABSTRACT FROM AUTHOR]

Abstract: The food web structure and diets of 26 taxa of benthic boundary layer (BBL) zooplankton on the Beaufort Sea shelf were studied using carbon and nitrogen stable isotopes and fatty acids. Mean δ 15N values ranged from 7.3‰ for the amphipod Melita formosa to 14.9‰ for an unidentified polychaete, suggesting that taxa sampled came from three trophic levels. For 8 taxa, the lightest carbon signature occurred near the mouth of the Mackenzie River. Stable isotope ratios helped clarify the origin of signature fatty acids. Levels of certain polyunsaturated fatty acids (PUFA) were negatively correlated with δ 15N, with the exception of 22:6ω3, which was positively correlated with δ 15N, suggesting that this essential PUFA was retained through the food web. Discriminant analysis proved to be a powerful tool, predicting taxa from fatty acid profiles with 99% accuracy, and revealing strong phylogenetic trends in fatty acid profiles. The amphipod Arrhis phyllonyx had higher levels of ω6 PUFA, especially 20:4ω6 with several possible sources, than other peracarid crustaceans. The holothurian had high levels of odd numbered and branched chain fatty acids, indicative of bacterial consumption, while fatty acids of phytoplankton origin were important discriminants for Calanus hyperboreus and the chaetognaths Eukrohnia hamata and Parasagitta elegans. This relationship indicates that the conventional phytoplankton-copepod-chaetognath food web found in the water column also exists in the BBL. This observation, as well as generally low δ 15N and high levels of certain PUFA in samples with lower δ 15N, strongly suggests that BBL zooplankton on the Beaufort Sea shelf have access to fresh material of phytoplankton origin either by feeding on sedimenting matter or by active migration to surface waters. [Copyright &y& Elsevier]

Toxic effects of petroleum to marine zooplankton have been generally investigated using dissolved petroleum hydrocarbons and in the absence of sunlight. In this study, we determined the influence of natural ultraviolet B (UVB) radiation on the lethal and sublethal toxicity of dispersed crude oil to naupliar stages of the planktonic copepods Acartia tonsa , Temora turbinata and Pseudodiaptomus pelagicus . Low concentrations of dispersed crude oil (1 μL L −1 ) caused a significant reduction in survival, growth and swimming activity of copepod nauplii after 48 h of exposure. UVB radiation increased toxicity of dispersed crude oil by 1.3–3.8 times, depending on the experiment and measured variables. Ingestion of crude oil droplets may increase photoenhanced toxicity of crude oil to copepod nauplii by enhancing photosensitization. Photoenhanced sublethal toxicity was significantly higher when T. turbinata nauplii were exposed to dispersant-treated oil than crude oil alone, suggesting that chemical dispersion of crude oil may promote photoenhanced toxicity to marine zooplankton. Our results demonstrate that acute exposure to concentrations of dispersed crude oil and dispersant (Corexit 9500) commonly found in the sea after oil spills are highly toxic to copepod nauplii and that natural levels of UVB radiation substantially increase the toxicity of crude oil to these planktonic organisms. Overall, this study emphasizes the importance of considering sunlight in petroleum toxicological studies and models to better estimate the impact of crude oil spills on marine zooplankton. [ABSTRACT FROM AUTHOR]

Tissue stable isotopes can be used for dietary reconstruction provided that the factors influencing turnover rates and trophic discrimination factors (TDFs) between consumer tissues and diet are known. This experiment quantified δ 13 C and δ 15 N dynamics in muscle and liver tissues in lab-reared juvenile marine fish after a switch from a high quality control diet to medium and low quality diets with decreasing protein and lipid contents. Turnover of δ 15 N in the liver was strongly influenced by metabolism, equilibrating 3 × faster compared to muscle for both diets. Nitrogen TDFs were dependent on diet quality, with values ranging from 3.0–6.5‰ in the muscle and 1.5–3.0‰ in the liver. The effects of mathematical lipid correction on δ 13 C turnover and discrimination were examined by developing novel empirical equations involving C:N ratios and lipid δ 13 C values. Lipid correction affected estimates of isotope turnover in the low quality diet treatment, with lipid-corrected muscle carbon isotopes equilibrating to diet 2 × faster than non-corrected muscle, due to lipid retention increasing turnover estimates for non-corrected values. Conversely, lipid-corrected liver half-lives were 4.4 × slower than non-corrected liver because lipid catabolism increased turnover rates for non-corrected values. A shift in control fish liver carbon TDFs of 2.1 and 1.7‰ for non-corrected and lipid-corrected values, respectively, between the beginning and end of the experiment was attributed to a 32% increase in lipid content. These results demonstrate that metabolic routing of lipid macromolecules strongly influences tissue-specific turnover, and is important to consider when reconstructing trophic dynamics. [ABSTRACT FROM AUTHOR]

BACKGROUND: Visceral and subcutaneous abdominal fat parameters have been associated with worse surgical outcomes in colorectal cancer but have not been investigated in diverticulitis. METHODS: Volumetric fat parameters were measured on preoperative computed tomography scans from 211 diverticulitis patients. Primary outcome was a serious postoperative complication (Clavien- Dindo grades 2-4). Variables including age, disease duration, American Society of Anesthesiology score, ostomy, immunosuppression, body mass index, and volumetric fat parameters were examined. SPSS was used for statistics. RESULTS: The serious postoperative complication rate was 12.7%. On univariate analysis, several factors including older age (P = .0001), ostomy creation (P = .02), higher visceral fat (VF, P = .01), emergent surgery (P = .05), and higher American Society of Anesthesiology score (P = .05) were associated with complications. On multivariate regression analysis, only VF was independently associated with complications. CONCLUSIONS: Diverticulitis patients with high VF are more likely to develop complications after sigmoidectomy. VF measurement may potentially be used as a tool to assist in surgical decision making and prediction of outcomes. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine if an increased incidence of incisional hernias is present in patients undergoing sigmoidectomy for diverticulitis vs cancer. The pathophysiology of diverticulitis is poorly understood, but might involve a collagen vascular abnormality that can predispose to incisional hernia. Study Design: In this IRB-approved, retrospective study, patients who underwent sigmoid colectomies for diverticulitis or cancer between January 2003 and September 2012 were studied. Exclusion criteria included the development of surgical site infections and neoadjuvant chemoradiotherapy. A multivariate logistic regression was used with covariate adjustments for known risk factors for hernia development. Results: Four hundred forty-two patients (mean age 59.3 ± 13.9 years) with a median follow-up of 30 months were analyzed. The incidence of incisional hernia was 15.1% in diverticulitis patients vs 5.8% in the cancer cohort (41 of 271 vs 10 of 171; p = 0.003). Univariate analysis of risk factors associated with postoperative incisional hernia included steroid use (p = 0.007), wound packing (p = 0.001), higher American Society of Anesthesiologists classification (p = 0.001), absorbable suture closure (p = 0.02), blood transfusion (p = 0.04), stoma formation (p = 0.02), increased body mass index (p = 0.008), and history of incisional hernia (p = 0.00008). Multivariate logistic regression demonstrated a persistent association between diverticulitis and hernia development (p = 0.01). Odds of a hernia developing after sigmoidectomy for diverticulitis were 2.82 times greater than in the cancer cohort (95% CI, 1.3–6.6). Conclusions: The incidence of an incisional hernia developing after a sigmoid colectomy is significantly higher when performed for diverticulitis as compared with cancer. This might be due to a connective tissue disorder, which predisposes to development of both diverticula and hernias. [ABSTRACT FROM AUTHOR]