2nd Propedeutical Department of Surgery, Hippokration Hospital, A Building, 5th Floor, 49 Constantinoupoleos St, 54642 Thessaloniki, Greece.
Tech Coloproctol. 2011 Oct;15 Suppl 1:S9-12. doi: 10.1007/s10151-011-0745-x.
Diverticular disease is a common problem in the western population and sometimes leads to serious complications such as hemorrhage, bowel stenosis, obstruction, abscesses, fistulae, bowel perforation, and peritonitis. The severity of these complications can differ, and it is not always clear which procedure is indicated in each case and what measures should be followed before bringing the patient into the operating room. Certain operations have high rates of morbidity and mortality, especially in compromised patients. Along with advancements in imaging and minimally invasive techniques, the indications for surgery have currently being adapted to "damage limitation" or "down-staging" protocols, which seem to offer improved results. There are still some questions to be solved in the following years by prospective studies, such as the usefulness of laparoscopic lavage in purulent peritonitis or of Hartmann's procedure in fecal peritonitis. These indications, based on current literature, are systematically discussed in the present review.
憩室疾病在西方人群中较为常见，有时会导致严重并发症，如出血、肠狭窄、梗阻、脓肿、瘘管、肠穿孔和腹膜炎。这些并发症的严重程度可能不同，而且在每种情况下并不总是清楚地表明哪种手术方法是指征，以及在将患者送入手术室之前应采取哪些措施。某些手术的发病率和死亡率较高，尤其是在身体状况不佳的患者中。随着影像学和微创技术的进步，目前手术指征已经适应了“损伤控制”或“降级”方案，这些方案似乎提供了更好的结果。在未来几年，还需要前瞻性研究来解决一些问题，例如腹腔镜灌洗在脓性腹膜炎中的作用或Hartmann 手术在粪便性腹膜炎中的作用。根据目前的文献，本文系统地讨论了这些适应证。
