Alvarez Jose A, Baldonedo Ricardo F, Bear Isabel G, Otero Jorge, Pire Gerardo, Alvarez Paloma, Jorge Jose I
Service of General Surgery, Hospital San Agustín, Avilés, Spain.
Dig Surg. 2007;24(6):471-6. doi: 10.1159/000111823. Epub 2007 Nov 29.
This study was conducted to assess the presentation, management, and outcomes of patients with acute sigmoid diverticulitis requiring hospitalization.
From 1986 to 2005, the medical records of 265 patients treated for acute sigmoid diverticulitis requiring hospitalization were retrospectively analyzed. Data were collected with regard to patient's demographics, clinical characteristics, presentations of acute diverticulitis, treatment, morbidity, and mortality.
Only 47 patients (17.7%) had a previous diverticulitis episode. Of the 265 patients, 166 (62.6%) were managed without operation, and 99 (37.4%) underwent surgery. Overall and major morbidity in the whole series were 30.2 (80/265) and 15.5% (40/265), respectively; whereas among the patients with surgical management, were 72.7 (72/99), and 35.3% (35/99), respectively. Overall and postoperative mortality rates were 2.6 (7/265) and 6.1% (6/99), respectively. Older age, steroid use, perforation, and co-morbidities were significantly associated with unfavorable outcomes.
It was concluded that surgery for acute sigmoid diverticulitis requiring hospitalization carries important morbidity and mortality. To achieve improvements in outcome, a selective therapeutic approach should be considered, choosing the best surgical procedure for each complication of diverticular disease.
本研究旨在评估需住院治疗的急性乙状结肠憩室炎患者的临床表现、治疗及预后。
回顾性分析1986年至2005年间265例因急性乙状结肠憩室炎需住院治疗患者的病历。收集患者的人口统计学资料、临床特征、急性憩室炎的表现、治疗、发病率及死亡率等数据。
仅47例患者（17.7%）曾有憩室炎发作史。265例患者中，166例（62.6%）未行手术治疗，99例（37.4%）接受了手术。整个系列的总体发病率和主要发病率分别为30.2%（80/265）和15.5%（40/265）；而在接受手术治疗的患者中，分别为72.7%（72/99）和35.3%（35/99）。总体死亡率和术后死亡率分别为2.6%（7/265）和6.1%（6/99）。年龄较大、使用类固醇、穿孔及合并症与不良预后显著相关。
得出结论，因急性乙状结肠憩室炎需住院治疗的手术具有重要的发病率和死亡率。为改善预后，应考虑采用选择性治疗方法，针对憩室病的每种并发症选择最佳手术方式。
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