Parker Maile E, Mathis Kellie L, Kelley Scott R
Mayo Clinic Rochester, Department of Surgery, Rochester, MN, USA.
Mayo Clinic Rochester, Department of Surgery, Division of Colon and Rectal Surgery, Rochester, MN, USA.
Int J Colorectal Dis. 2017 Dec;32(12):1767-1770. doi: 10.1007/s00384-017-2911-8. Epub 2017 Sep 30.
Patients with polycystic kidney disease (PKD) who have had a kidney transplant have an increased risk of diverticular disease and complicated diverticulitis. Literature is limited regarding the severity of diverticulitis in patients with PKD who have not had a transplant. We aim to assess whether patients with PKD, with and without renal transplant, have a similar course of diverticulitis.
A retrospective review of all adult PKD patients at our institution diagnosed with diverticulitis between 2000 and 2016 was conducted. Patients without documented PKD and diverticulitis were excluded. We compared PKD patients with and without renal transplantation.
A total of 41 patients were identified. Mean age was 60 (± 12), and 56% were female. Fourteen patients had undergone renal transplantation. Five (19%) non-transplant patients had complicated diverticulitis, compared to 43% (n = 6) transplanted (p = 0.33). Fifteen (56%) non-transplant and 8 (57%) transplant patients had recurrent diverticulitis (p = 1.00). Three (11%) non-transplant and 5 (36%) transplanted patients had recurrent complicated diverticulitis. Eight (30%) non-transplant and 7 (50%) transplant patients underwent surgery (p = 0.31). All 8 non-transplant patients underwent sigmoid resection with primary anastomosis without diversion. In the transplant group, 3 Hartmann procedures and 1 sigmoid resection with and 3 without diversion were performed. There was one in-hospital death in each group.
In our group of patients, there was no difference in rate of recurrent diverticulitis, diverticulitis complications, or operative intervention in patients with PKD with and without renal transplant. The renal transplant group had a higher rate of recurrent, complicated diverticulitis.
接受过肾移植的多囊肾病(PKD)患者患憩室病和复杂性憩室炎的风险增加。关于未接受移植的PKD患者憩室炎严重程度的文献有限。我们旨在评估有和没有肾移植的PKD患者憩室炎的病程是否相似。
对2000年至2016年间在我们机构诊断为憩室炎的所有成年PKD患者进行回顾性研究。排除无PKD和憩室炎记录的患者。我们比较了有和没有肾移植的PKD患者。
共确定41例患者。平均年龄为60岁(±12),56%为女性。14例患者接受了肾移植。5例(19%)未移植患者发生复杂性憩室炎,而移植患者为43%(n = 6)(p = 0.33)。15例(56%)未移植和8例(57%)移植患者有复发性憩室炎(p = 1.00)。3例(11%)未移植和5例(36%)移植患者有复发性复杂性憩室炎。8例(30%)未移植和7例(50%)移植患者接受了手术(p = 0.31)。所有8例未移植患者均接受了乙状结肠切除术并一期吻合,未行造口术。在移植组,进行了3例Hartmann手术、1例乙状结肠切除术(其中1例有造口术,3例无造口术)。每组各有1例住院死亡。
在我们的患者组中,有和没有肾移植的PKD患者复发性憩室炎发生率、憩室炎并发症或手术干预方面没有差异。肾移植组复发性、复杂性憩室炎的发生率较高。