Tolins S H
JAMA. 1975 May 26;232(8):830-2.
In the past 5 1/2 years, 71 patients with diverticulitis were operated on--20.8% of all cases of diverticulitis admitted to the Bronx Municipal Hospital Center. Operative mortality was 22%, primarily because of delayed diagnosis, inadequate surgery, and a high incidence of associated disease. Only 20% of patients operated on had a previous history of diverticular disease. Hemorrhage was the indication for surgery in 16 cases; in this situation, a subtotal colectomy in one stage is the operation of choice. Perforation was the indication in 47 cases, eight of these being acute and with free air under the diaphragm. In cases with peritoneal contamination, a two-stage procedure (removing the diseased portion of colon at stage one) is advocated. Colostomy without drainage, or closure of a free perforation, is condemned.
在过去的五年半时间里，71例憩室炎患者接受了手术治疗，占布朗克斯市立医院中心收治的所有憩室炎病例的20.8%。手术死亡率为22%，主要原因是诊断延误、手术不充分以及合并症的高发病率。接受手术的患者中只有20%有憩室病病史。16例患者因出血而接受手术；在这种情况下，一期次全结肠切除术是首选手术方式。47例患者因穿孔而接受手术，其中8例为急性穿孔且膈下有游离气体。对于有腹膜污染的病例，主张采用两阶段手术（第一阶段切除患病的结肠部分）。不做引流的结肠造口术或游离穿孔的缝合术是不可取的。
