Oh Heung-Kwon, Han Eon Chul, Ha Heon-Kyun, Choe Eun Kyung, Moon Sang Hui, Ryoo Seung-Bum, Jeong Seung-Yong, Park Kyu Joo
Heung-Kwon Oh, Eon Chul Han, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul 110-744, South Korea.
World J Gastroenterol. 2014 Aug 7;20(29):10115-20. doi: 10.3748/wjg.v20.i29.10115.
To compare the outcome of the surgical management of left-sided and right-sided diverticular disease.
The medical records of 77 patients who were surgically treated for diverticular disease between 1999 and 2010 in a tertiary referral hospital were retrospectively reviewed. The study population was limited to cases wherein the surgical specimen was confirmed as diverticulosis by pathology. Right-sided diverticula were classified as those arising from the cecum, ascending colon, and transverse colon, and those from the descending colon, sigmoid colon, and rectum were classified as left-sided diverticulosis. To assess the changing trend of occurrence of diverticulosis, data were compared with two previous studies of 51 patients.
The proportion of left-sided disease cases was significantly increased compared to the results of our previous studies in 1994 and 2001, (27.5% vs 48.1%, P < 0.05). Moreover, no differences in gender, body mass index, multiplicity of the diverticula, fever, or leukocytosis were noted between patients with right-sided and left-sided disease. However, patients with right-sided disease were significantly younger (50.9 year vs 64.0 year, P < 0.01). Furthermore, left-sided disease was significantly associated with a higher incidence of complicated diverticulitis (89.2% vs 57.5%, P < 0.01), combined resection due to extensive inflammation (21.6% vs 5.0%, P < 0.05), operative complications (51.4% vs 27.5%, P < 0.05), and in-hospital mortality (10.8% vs 0%, P < 0.05), along with longer post-operative hospitalization duration (21.3 ± 10.2 d vs 10.6 ± 8.1 d, P < 0.05).
Compared with right-sided diverticular disease, the incidence of left-sided disease in Korea has increased since 2001 and is associated with worse surgical outcomes.
比较左侧和右侧憩室病的手术治疗结果。
回顾性分析1999年至2010年在一家三级转诊医院接受憩室病手术治疗的77例患者的病历。研究人群仅限于手术标本经病理证实为憩室病的病例。右侧憩室分为盲肠、升结肠和横结肠的憩室，降结肠、乙状结肠和直肠的憩室则归为左侧憩室病。为评估憩室病发生率的变化趋势，将数据与之前两项分别针对51例患者的研究进行比较。
与我们1994年和2001年的前期研究结果相比，左侧疾病病例的比例显著增加（27.5%对48.1%，P<0.05）。此外，右侧和左侧疾病患者在性别、体重指数、憩室数量、发热或白细胞增多方面未发现差异。然而，右侧疾病患者明显更年轻（50.9岁对64.0岁，P<0.01）。此外，左侧疾病与复杂憩室炎的发生率较高显著相关（89.2%对57.5%，P<0.01），因广泛炎症导致的联合切除术发生率较高（21.6%对5.0%，P<0.05），手术并发症发生率较高（51.4%对27.5%，P<0.05），住院死亡率较高（10.8%对0%，P<0.05），以及术后住院时间较长（21.3±10.2天对10.6±
