右侧急性憩室炎：单一西方中心的经验。

Right-sided acute diverticulitis: A single Western center experience.

机构信息

Unit of Emergency Surgery, Emergency Department, Policlinico S.Orsola-Malpighi, University of Bologna, Italy.

出版信息

Int J Surg. 2017 Aug;44:128-131. doi: 10.1016/j.ijsu.2017.06.025. Epub 2017 Jun 13.

DOI:10.1016/j.ijsu.2017.06.025

PMID:28627445

Abstract

INTRODUCTION

Right sided diverticular disease is a rare condition in Western countries whereas is common amongst Asian population. The aim of this study is to evaluate options and outcomes for the treatment of right colonic diverticulitis.

METHOD

We included only patients undergoing surgery with right colon diverticulitis (RCD) proven at histological specimen examination from September 2011 to December 2016.

RESULTS

We performed 18 operations for RCD. Age was lower compared to left sided disease (49 ± 16 vs 67 ± 14; P < 0.001). Three patients were Asian (16.7%). RCD was diagnosed preoperatively in 8 cases (44.4%), whereas appendicitis was suspected in 9 cases (50%) and neoplasm in one (5.6%). We performed resection with anastomosis in 13 patients (72.2%) and in 5 cases we performed a diverticulectomy. Laparoscopy was performed in 14 cases (77.8%). Postoperative morbidity occurred in 3 patients (16.7%; grade 2 or 3a according to Clavien-Dindo) with no mortality. No postoperative events occured after diverticulectomy with shorter hospital stay (4 ± 1.5 vs 11 ± 13; P = 0.022), as no recurrence or need for elective surgery after a mean follow-up of 20 months.

CONCLUSION

RCD is a rare but not irrelevant condition. Minimally invasive surgery is often feasible and complication rate is low. In selected patients, diverticulectomy can be a valid alternative to treat this condition providing improved postoperative results.

摘要

简介

右半结肠憩室疾病在西方国家较为罕见，但在亚洲人群中较为常见。本研究旨在评估右半结肠憩室炎（RCD）的治疗选择和结果。

方法

我们仅纳入了 2011 年 9 月至 2016 年 12 月期间在组织学标本检查中确诊为右结肠憩室炎（RCD）并接受手术治疗的患者。

结果

我们共进行了 18 例 RCD 手术。与左侧疾病相比，患者年龄更低（49±16 岁 vs 67±14 岁；P<0.001）。有 3 例患者为亚洲人（16.7%）。8 例（44.4%）术前诊断为 RCD，9 例（50%）疑诊为阑尾炎，1 例（5.6%）疑诊为肿瘤。我们对 13 例患者（72.2%）行切除吻合术，对 5 例患者行憩室切除术。14 例（77.8%）患者行腹腔镜手术。3 例（16.7%）患者发生术后并发症（根据 Clavien-Dindo 分级为 2 级或 3a 级），无死亡病例。憩室切除术的术后住院时间更短（4±1.5 天 vs 11±13 天；P=0.022），且术后并发症发生率更低，在平均 20 个月的随访后无复发或需要择期手术。