McConnell Elizabeth J, Tessier Deron J, Wolff Bruce G
Department of Surgery, Mayo Clinic Scottsdale, Scottsdale, Arizona, USA.
Dis Colon Rectum. 2003 Aug;46(8):1110-4. doi: 10.1007/s10350-004-7288-4.
The purpose of this study was to characterize the gender and age differences in patients with clinically symptomatic sigmoid diverticular disease requiring surgery.
All surgical patients hospitalized with proven diverticular disease requiring sigmoid resection from January 1988 to January 1998 were reviewed.
A total of 934 patients requiring surgical resection for diverticular disease were admitted. There were 443 men and 491 women with an average age of 64. Forty-nine patients presented with massive rectal bleeding (males, 3.6 percent; females, 1.6 percent), 329 with chronic diverticulitis (males, 15.8 percent; females, 19.3 percent), 61 with obstructive symptoms (males, 2.7 percent; females, 3.9 percent), 148 with fistulas (males, 8.0 percent; females, 7.8 percent), 170 with perforation (male, 8.7 percent; female, 9.4 percent), 79 with abscess (males, 4.0 percent; females, 4.5 percent), 59 with stricture (males, 2.2 percent; females, 4.0 percent), and 39 with acute diverticulitis (males, 2.2 percent; females, 1.9 percent). Overall, patients younger than 50 presented more often with chronic or recurrent diverticulitis.
Female patients present, on average, five years later than male with complications requiring surgery. Overall, men have a higher incidence of bleeding (P = 0.015), whereas women present more often with stricture and obstruction (P = 0.02). Young males present more with fistula (P = 0.03), whereas older males present with bleeding (P = 0.001). Young females present with perforation (P = 0.002), and older females present with chronic diverticulitis (P = 0.04) and stricture (P = 0.04).
本研究旨在描述需要手术治疗的有临床症状的乙状结肠憩室病患者的性别和年龄差异。
回顾了1988年1月至1998年1月期间因确诊憩室病需行乙状结肠切除术而住院的所有手术患者。
共有934例因憩室病需要手术切除的患者入院。其中男性443例，女性491例，平均年龄64岁。49例出现大量直肠出血（男性3.6%，女性1.6%），329例患有慢性憩室炎（男性15.8%，女性19.3%），61例有梗阻症状（男性2.7%，女性3.9%），148例有瘘管（男性8.0%，女性7.8%），170例有穿孔（男性8.7%，女性9.4%），79例有脓肿（男性4.0%，女性4.5%），59例有狭窄（男性2.2%，女性4.0%），39例有急性憩室炎（男性2.2%，女性1.9%）。总体而言，50岁以下的患者更常出现慢性或复发性憩室炎。
女性患者出现需要手术治疗的并发症的时间平均比男性晚五年。总体而言，男性出血发生率较高（P = 0.015），而女性更常出现狭窄和梗阻（P = 0.02）。年轻男性更多出现瘘管（P = 0.03），而老年男性出现出血（P = 0.001）。年轻女性出现穿孔（P = 0.002），老年女性出现慢性憩室炎（P = 0.04）和狭窄（P = 0.04）。
