Issa N, Dreznik Z, Dueck D S, Arish A, Ram E, Kraus M, Gutman M, Neufeld D
Department of Surgery A, Meir Hospital, Sapir Medical Center, and the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Colorectal Dis. 2009 Feb;11(2):198-202. doi: 10.1111/j.1463-1318.2008.01546.x. Epub 2008 May 3.
Antecedent attacks of diverticulitis are thought to increase the risk of complicated diverticulitis, and unless elective surgery is performed, a high proportion of patients with recurrent symptoms will require emergency operations for complicated diverticulitis with its associated morbidity. In this multicentre study, we aim to assess impact of previous attacks of diverticulitis on patients requiring an emergency surgical intervention.
All patients operated on as an emergency for complicated diverticulitis were retrospectively analysed. Patients were separated into two groups: group A included patients without previous history of diverticular disease, and group B those with previous attacks of diverticulitis.
A total of 96 patients were included in the study. Group A included 68 (70.8%) patients, and group B 28 (29.2%) patients. Generalized peritonitis was the reason for operation in 50 (73.5%) patients in-group A and only four (14%) patients in group B. Perforated diverticulitis occurred more often in group A, whereas pericolonic abscess and phlegmon formation occurred more commonly in group B. Resection was performed in all patients in group B; 50% had a Hartmann's procedure, and the other 50% patients had primary anastomosis. Hartmann's procedure was performed in 52 patients (76.5%) in group A, and 8 patients (11.7%) had resection and primary anastomosis. No difference in postoperative complications was identified between the groups.
Multiple attacks of diverticulitis are not associated with an increased risk of complicated diverticulitis. Recurrent episodes of diverticulitis are not associated with a less favourable outcome or an increased risk of fatality if complications ensue.
憩室炎的前驱发作被认为会增加复杂性憩室炎的风险，并且除非进行择期手术，否则大部分有复发症状的患者将因复杂性憩室炎及其相关并发症而需要进行急诊手术。在这项多中心研究中，我们旨在评估既往憩室炎发作对需要急诊手术干预的患者的影响。
对所有因复杂性憩室炎接受急诊手术的患者进行回顾性分析。患者被分为两组：A组包括既往无憩室病病史的患者，B组包括既往有憩室炎发作的患者。
本研究共纳入96例患者。A组有68例（70.8%）患者，B组有28例（29.2%）患者。A组50例（73.5%）患者因弥漫性腹膜炎接受手术，而B组仅有4例（14%）患者。穿孔性憩室炎在A组更常见，而结肠周围脓肿和蜂窝织炎在B组更常见。B组所有患者均进行了切除术；50%的患者接受了Hartmann手术，另外50%的患者进行了一期吻合术。A组52例（76.5%）患者接受了Hartmann手术，8例（11.7%）患者进行了切除和一期吻合术。两组术后并发症无差异。
憩室炎的多次发作与复杂性憩室炎风险增加无关。憩室炎复发与较差的预后或如果出现并发症时死亡风险增加无关。
