Gemlo Brett T
Division of Colon and Rectal Surgery, University of Minnesota, St. Paul, MN 55102, USA.
Clin Colon Rectal Surg. 2004 Aug;17(3):183-6. doi: 10.1055/s-2004-832700.
Elective surgical resection in cases of diverticulitis should be offered to patients who have experienced two episodes. High-risk patients such as immunocompromised individuals or transplant patients may warrant resection after one episode. It is controversial whether young patients or patients with right-sided diverticulitis need to be treated differently. Chronic diverticulitis can be successfully treated surgically in selected cases. Adequate surgical resection margins should include the top of the true rectum and the proximal extent of thickened inflamed colon to minimize the risk of recurrence. Careful operative planning and the use of proximal diversion if unsuspected significant inflammatory changes are encountered will improve surgical outcomes.
对于经历过两次憩室炎发作的患者，应考虑进行择期手术切除。免疫功能低下个体或移植患者等高风险患者在发作一次后可能需要进行切除。年轻患者或右侧憩室炎患者是否需要区别治疗存在争议。在某些选定的病例中，慢性憩室炎可以通过手术成功治疗。充分的手术切缘应包括直肠真顶部和增厚发炎结肠的近端范围，以尽量降低复发风险。如果遇到未预料到的明显炎症变化，仔细的手术规划和近端转流的使用将改善手术效果。
