Department of General, Visceral, Vascular and Thoracic Surgery, Hospital of Liestal, affiliated with the University of Basel, Rheinstrasse, Liestal, Switzerland.
Colorectal Dis. 2012 Mar;14(3):e111-6. doi: 10.1111/j.1463-1318.2011.02801.x.
The study aimed to determine the patient's view on the timing of elective resection for sigmoid diverticulitis.
A questionnaire was answered by 162 (69%) of 236 consecutive patients who had a resection of the rectosigmoid for diverticulitis from July 2002 to August 2005. Patients (n=45) having resection at or after the first inflammatory attack were excluded, leaving 117 eligible for analysis. Questions asked included those concerning symptoms before surgery, improvement of symptoms after surgery and the timing of surgery.
Patient assessment of symptoms after surgery was as follows: no improvement (2%; n=2), some improvement (10%; n=12), marked improvement (34%; n=39) and complete resolution (54%; n=63). Forty-five (38%) patients would have preferred an earlier operation. Preference for earlier surgery related to the number of previous inflammatory attacks was expressed as follows: 13 (34%) of 38 patients after two inflammatory attacks, 5 (18%) of 28 patients after three, seven (37%) of 19 patients after four, four (44%) of nine patients after five, and 16 (70%) of 23 patients after six or more inflammatory attacks would have preferred earlier surgery. Statistically significant factors influencing this potential choice were number of episodes of pain (P=0.006, OR=1.23, 95% CI: 1.060-1.430) and number of attacks of inflammation (P=0.048, OR=1.27, 95% CI: 1.002-1.598).
Surgery for recurrent diverticulitis resulted in a marked improvement or complete relief of symptoms in 88% of patients. A large proportion of patients with recurrent episodes of sigmoid diverticulitis would have preferred earlier resection.
本研究旨在确定患者对择期行乙状结肠切除术治疗乙状结肠憩室炎时间的看法。
对 2002 年 7 月至 2005 年 8 月连续接受直肠乙状结肠切除术治疗憩室炎的 236 例患者中的 162 例（69%）进行问卷调查。排除首次炎症发作时或之后行切除术的患者（n=45），剩余 117 例符合分析条件。问卷内容包括手术前症状、手术后症状改善情况和手术时机等问题。
患者术后症状评估结果如下：无改善（2%；n=2）、部分改善（10%；n=12）、明显改善（34%；n=39）和完全缓解（54%；n=63）。45（38%）例患者更愿意行早期手术。对早期手术的偏好与之前炎症发作次数有关，具体如下：两次炎症发作后 38 例患者中有 13 例（34%）、三次炎症发作后 28 例患者中有 5 例（18%）、四次炎症发作后 19 例患者中有 7 例（37%）、五次炎症发作后 9 例患者中有 4 例（44%）、六次或以上炎症发作后 23 例患者中有 16 例（70%）更愿意行早期手术。影响这一潜在选择的统计学显著因素为疼痛发作次数（P=0.006，OR=1.23，95%CI：1.060-1.430）和炎症发作次数（P=0.048，OR=1.27，95%CI：1.002-1.598）。
对于复发性憩室炎患者，手术治疗可使 88%的患者症状明显改善或完全缓解。复发性乙状结肠憩室炎患者中，相当一部分患者更愿意行早期切除术。
