Contemporary Surgical Strategies in Diverticular Disease and Colorectal Sepsis

The field of gastrointestinal surgery faces ongoing complexity in the management of diverticular disease complicated by colorectal sepsis. Acute presentations often challenge clinicians with rapidly evolving clinical scenarios, diverse patient populations, and a spectrum of available interventions. Despite advances in diagnostics, operative techniques, and post-operative care, optimal strategies remain contested, especially when weighing urgency, patient frailty, surgical risk, and long-term functional outcomes. Recent landmark studies have challenged conventional algorithms, such as the routine use of Hartmann’s procedure or immediate colectomy, by exploring the role of nonoperative management, damage control surgery, and individualized decision pathways. Enhanced recovery protocols and antibiotic stewardship further influence treatment success and post-operative morbidity. However, gaps persist regarding patient-centered outcomes, indications for elective versus emergency interventions, the impact of patient comorbidities such as frailty, and the nuances of shared decision-making in real-world, multidisciplinary care settings.This Research Topic aims to critically examine state-of-the-art decision-making in the management of diverticular disease complicated by colorectal sepsis. The focus is on furthering our understanding of patient selection, timing of interventions, and the integration of contemporary protocols to optimize outcomes. Specific objectives include exploring the comparative effectiveness of emerging operative and nonoperative techniques, elucidating the benefits and limitations of “damage control” concepts versus definitive procedures, and advancing frameworks for individualized, patient-focused care including consideration of frailty and individual patient needs in the context of comorbidities. This initiative seeks to address unanswered questions about the best practices, unresolved controversies, and knowledge gaps that persist despite the proliferation of guidelines and recent multicenter trials.Recognizing the complexity of diverticular disease with septic complications, the scope of this Research Topic is confined to clinical, translational, and outcomes-based research covering management across acute and elective settings. We particularly encourage submissions that address multidisciplinary and patient-centered approaches.To gather further insights in surgical management from emergency to elective care, we welcome articles addressing, but not limited to, the following themes:o Evolving criteria for operative versus nonoperative management;o Outcomes of Hartmann’s procedure, primary anastomosis, and alternative surgical techniques;o Role of laparoscopic and robotic procedures;o Percutaneous interventions and timing of operative strategies;o Implementation of enhanced recovery after surgery (ERAS) in emergency scenarios;o Antibiotic stewardship and infection control strategies;o Impact of frailty and comorbidities on perioperative outcomes;o Strategies for optimizing shared decision-making in high-risk patients;o Timing, indications, and outcomes of stoma reversal;o Multidisciplinary protocols for individualized care pathways;o Updates on radiologic assessment, risk prediction, and monitoring strategies.This Research Topic welcomes, but is not limited to, original research articles, systematic reviews, meta-analyses, case series, clinical guidelines, and perspectives. Topic editors: Marie-Christin Weber, Josefine Schardey Source: https://www.frontiersin.org/research-topics/78277/contemporary-surgical-strategies-in-diverticular-disease-and-colorectal-sepsis