Natarajan Subramanian, Ewings Ember Lee, Vega Roland J
Department of Surgery, University of Winsconsin Medical School, and Meriter Hospital, Madison, WI 53715, USA.
Surgery. 2004 Oct;136(4):725-30. doi: 10.1016/j.surg.2004.06.013.
Laparoscopic sigmoid colectomy has become an acceptable method of surgical treatment for diverticulitis. However, an optimal waiting period before attempting elective laparoscopic colectomy has not been established. We sought to evaluate the relationship between the time interval from an acute episode of diverticulitis to laparoscopic colectomy and surgical outcomes.
All patients undergoing laparoscopic colectomy during a period of 10 years in a single institution were studied. Retrospectively collected data included patient demographics, American Society of Anesthesiologists score, prior episodes of diverticulitis, interval between last attack and operation, operative time, complications, conversion, and recovery period.
A total of 120 patients were included; 89 had a primary diagnosis of diverticulitis. Mean interval from acute diverticulitis to operation was 64 days (range, 1 to 240). Median number of episodes of diverticulitis before colectomy was 3 (range, 1 to 10). Ten patients (11%) required conversion from laparoscopic to open colectomy. Neither interval from acute attack to operation nor number of prior episodes of diverticulitis was associated with any significantly increased rate of conversion to open colectomy, complication rate, operative time, or recovery period (P=not significant).
Our study showed no direct relationship between surgical timing after acute diverticulitis and complication or conversion rates after elective laparoscopic sigmoid colectomy.
腹腔镜乙状结肠切除术已成为憩室炎可接受的手术治疗方法。然而，择期腹腔镜结肠切除术之前的最佳等待期尚未确定。我们试图评估从憩室炎急性发作到腹腔镜结肠切除术的时间间隔与手术结果之间的关系。
对一家机构10年内接受腹腔镜结肠切除术的所有患者进行研究。回顾性收集的数据包括患者人口统计学资料、美国麻醉医师协会评分、既往憩室炎发作情况、上次发作与手术之间的间隔、手术时间、并发症、中转情况和恢复期。
共纳入120例患者；89例初步诊断为憩室炎。从急性憩室炎到手术的平均间隔时间为64天（范围1至240天）。结肠切除术前行憩室炎发作的中位数为3次（范围1至10次）。10例患者（11%）需要从腹腔镜手术中转至开放手术。从急性发作到手术的间隔时间和既往憩室炎发作次数均与中转至开放手术、并发症发生率、手术时间或恢复期的显著增加无关（P值无统计学意义）。
我们的研究表明，急性憩室炎后的手术时机与择期腹腔镜乙状结肠切除术后的并发症或中转率之间无直接关系。
