Unit of Emergency Surgery, Emergency Department, Policlinico S.Orsola-Malpighi, University of Bologna, Italy.
Unit of Emergency Surgery, Emergency Department, Policlinico S.Orsola-Malpighi, University of Bologna, Italy.
Int J Surg. 2017 Aug;44:128-131. doi: 10.1016/j.ijsu.2017.06.025. Epub 2017 Jun 13.
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.
We included only patients undergoing surgery with right colon diverticulitis (RCD) proven at histological specimen examination from September 2011 to December 2016.
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.
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.
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。
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。
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。
RCD 虽然少见，但并非无关紧要。微创手术通常可行，且并发症发生率低。在选择合适的患者中，憩室切除术可能是治疗该疾病的有效替代方法，可提供更好的术后结果。
