Department of General Surgery, Hospital de São João, Al. Prof. Hernâni Monteiro, HSJ, 4200-319 Porto, Portugal.
World J Gastroenterol. 2011 Jan 14;17(2):207-12. doi: 10.3748/wjg.v17.i2.207.
To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently.
This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1, 2004 and December 31, 2007. Diverticulitis was stratified according to the Hinchey classification. Patients were divided into 2 populations: group A ≤ 50 years (n = 31); group B > 50 years (n = 126). Mean patient follow-up was 15 mo.
The median age was 60 years. A significantly higher proportion of patients in group B presented with complicated diverticulitis (36.5% vs 12.9%, P = 0.01). Recurrence was more frequent in group A (25.8% vs 11.1%, P = 0.03) and the mean time-to-recurrence was shorter (12 mo vs 28 mo, P = 0.26). The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stage I and none of the patients required emergency surgery. In multivariate analysis, only age (P = 0.024) was identified as an independent prognostic factor for recurrence.
Based on the results of this study, the authors recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.
比较年轻患者和老年患者急性憩室炎的自然病史和病程，并评估年轻患者是否应采用不同的治疗方法。
本研究回顾性分析了 2004 年 1 月 1 日至 2007 年 12 月 31 日期间接受急性憩室炎治疗的 157 例患者。根据 Hinchey 分类对憩室炎进行分层。患者分为 2 组：A 组≤50 岁（n=31）；B 组＞50 岁（n=126）。平均随访患者 15 个月。
中位年龄为 60 岁。B 组中患有复杂憩室炎的患者比例明显更高（36.5%比 12.9%，P=0.01）。A 组的复发率更高（25.8%比 11.1%，P=0.03），复发的平均时间更短（12 个月比 28 个月，P=0.26）。最严重的复发性急性憩室炎发作被归类为 Hinchey Ⅰ期，无患者需要紧急手术。多因素分析显示，只有年龄（P=0.024）是复发的独立预后因素。
基于本研究结果，作者建议根据疾病的严重程度而不是患者的年龄来管理憩室炎。
