Department of Surgery, Hallym University College of Medicine, 896 Pyeongchon-dong, Dongan-gu, Anyang, 431-070, Republic of Korea.
World J Surg. 2011 May;35(5):1118-22. doi: 10.1007/s00268-011-1048-0.
Initial conservative management may be the mainstay of therapy for uncomplicated right colonic diverticulitis. However, definitive treatment guidelines have not yet been established. In this study, we assessed the efficacy of outpatient management versus inpatient management for preventing recurrence of this condition.
Between 2007 and 2009, a total of 103 patients were consecutively enrolled at the first attack of uncomplicated right colonic diverticulitis. In this prospective observational study, 40 patients underwent an outpatient management regimen consisting of oral antibiotics (for 4 days), and 63 patients underwent an inpatient management regimen that included bowel rest and intravenous antibiotics (for 7-10 days). The treatment was selected by the patient. Failure to respond to therapy and the incidence of recurrence of this condition were assessed.
Both groups of patients were treated successfully, and their symptoms were relieved. The patients were followed up for a median time of 21 months. Of the 40 patients with short-term oral antibiotic therapy on an outpatient basis, disease recurrence was observed in 4 patients (10%). Of these four patients, one underwent surgery and the remaining three were treated nonoperatively. Of the 63 patients on inpatient management, recurrence was observed in 7 patients (11%). Of these seven patients, one underwent surgery and the remaining six were treated nonoperatively.
Outpatient management with short-term oral antibiotic therapy for the treatment of uncomplicated right colonic diverticulitis is as effective as inpatient management in regard to preventing disease recurrence.
对于单纯性右结肠憩室炎，初始的保守治疗可能是主要的治疗方法。然而，目前尚未建立明确的治疗指南。在本研究中，我们评估了门诊管理与住院管理在预防该疾病复发方面的疗效。
在 2007 年至 2009 年期间，共有 103 例单纯性右结肠憩室炎首次发作的患者连续入组。在这项前瞻性观察性研究中，40 例患者接受了门诊管理方案，包括口服抗生素（4 天），63 例患者接受了住院管理方案，包括肠道休息和静脉内抗生素（7-10 天）。治疗方案由患者选择。评估治疗失败和该疾病复发的发生率。
两组患者均成功治疗，症状缓解。对患者进行了中位数为 21 个月的随访。在 40 例接受短期口服抗生素门诊治疗的患者中，有 4 例（10%）出现疾病复发。这 4 例患者中，1 例接受了手术，其余 3 例接受了非手术治疗。在 63 例接受住院管理的患者中，有 7 例（11%）出现疾病复发。这 7 例患者中，1 例接受了手术，其余 6 例接受了非手术治疗。
对于单纯性右结肠憩室炎，采用短期口服抗生素门诊治疗与住院管理在预防疾病复发方面同样有效。
