Cavallaro Antonio, Loschiavo Vincenzo, Potenza Angelo Eugenio, Modugno Pietro, Fabbri Maria Cristina, Revelli Luca, Colli Rosa
Istituto di Semeiotica Chirurgica, Università Cattolica del Sacro Cuore, Roma.
Chir Ital. 2002 Sep-Oct;54(5):693-8.
This study reports on 10 years of experience in observing diverticular disease. The study considers 77 patients, 41 males and 36 females, aged from 50 to 88 years (mean age: 70 years), observed from January 1991 to December 2001. Sixty-two patients were admitted from the Accident and Emergency Unit and 15 were elected patients. Five patients underwent emergency surgery, while 72 received only antibiotic therapy. The overall mortality rate was 0. The morbidity rate was 22% in those patients undergoing emergency surgery. In only one of the elected patients was wound suppuration detected. Diverticular disease, in most cases, is treated by antibiotic therapy alone, but in 30% of cases surgery is necessary. Colon resection and immediate anastomosis are the first choice operation also in the emergency setting, provided local conditions (inflammation, septic contamination) make anastomosis safe. In patients with major peritoneal contamination, Hartman's operation and subsequent recanalization after 6 months are to be preferred.
本研究报告了10年观察憩室病的经验。该研究纳入了77例患者,年龄在50至88岁之间(平均年龄:70岁),其中男性41例,女性36例,观察时间为1991年1月至2001年12月。62例患者来自急诊室,15例为择期患者。5例患者接受了急诊手术,72例仅接受了抗生素治疗。总死亡率为0。急诊手术患者的发病率为22%。仅在1例择期患者中发现伤口化脓。在大多数情况下,憩室病仅通过抗生素治疗,但在30%的病例中需要手术。只要局部条件(炎症、感染污染)使吻合安全,结肠切除并立即吻合也是急诊情况下的首选手术。对于有严重腹膜污染的患者,首选Hartman手术并在6个月后进行后续再通术。