Le Néel J C, Guiberteau B, Borde L, Sartre J Y, Bourseau J C
Clinique chirurgicale A. Hôtel-Dieu, CHU, Nantes.
Chirurgie. 1992;118(8):457-62; discussion 462-3.
From 1981 to 1991 inclusive, 188 operations were carried out for diverticular sigmoiditis. One hundred and thirty-nine patients were operated in emergency for acute complications (123) or fistulae (16), and another 49 had surgery scheduled outside acute crisis periods. Mortality and morbidity respectively are 16.5 and 31% in the first group, against 0 and 12% in the second one. Similarly, the stay in hospital varies from 13 days for scheduled surgery to 23 days for emergent surgery, the latter also requiring to account for risks and for the duration of a second operation that is far from exceptional (40%). Considering the severity of some evolutive complications, the authors advocate early radical surgery for symptomatic diverticular sigmoiditis, after the second crisis or as soon as the first one if it has been severe, and in young subjects and patients at risks.
在1981年至1991年(含)期间,针对乙状结肠憩室炎进行了188例手术。139例患者因急性并发症(123例)或瘘管(16例)接受了急诊手术,另外49例在急性发作期以外安排了手术。第一组的死亡率和发病率分别为16.5%和31%,而第二组分别为0和12%。同样,住院时间从择期手术的13天到急诊手术的23天不等,后者还需要考虑风险以及二次手术的时长(二次手术并不罕见,占比40%)。考虑到一些进展性并发症的严重性,作者主张对于有症状的乙状结肠憩室炎,在第二次发作后或如果第一次发作严重则在第一次发作后尽早进行根治性手术,尤其是年轻患者和有风险的患者。