Häring R U, Salm R
Abt. für Allgemein- und Viszeralchirurgie, Endoskopische Chirurgie, St.-Josefs-Krankenhaus, Freiburg.
MMW Fortschr Med. 2003 Oct 2;145(40):32-5.
The first attack of uncomplicated diverticulitis is treated conservatively. Sigmoid resection is indicated for recurrent diverticulitis, in patients with manifest stenosis or fistula and for such emergencies as perforation, ileus or bleeding. Early surgery after the first episode is recommended for patients under 50 years of age, or immunocompromised patients. This is particularly true for patients with radiological signs of severe diverticulitis. Today elective sigmoid resection is a laparoscopic procedure. Properly carried out, the operation effects a definitive cure. The morbidity and mortality of the operation is low, and re-operations for recurrent diverticulitis are the exception. In the emergency situation a two-stage procedure is often necessary.
单纯性憩室炎的首次发作采用保守治疗。乙状结肠切除术适用于复发性憩室炎、有明显狭窄或瘘管的患者以及穿孔、肠梗阻或出血等紧急情况。对于50岁以下的患者或免疫功能低下的患者，建议在首次发作后尽早进行手术。对于有严重憩室炎放射学征象的患者尤其如此。如今，选择性乙状结肠切除术是一种腹腔镜手术。操作得当，该手术可实现根治。手术的发病率和死亡率较低，因复发性憩室炎而再次手术的情况较为罕见。在紧急情况下，通常需要分两期进行手术。
