Warwas Felix Benjamin, Schneider Berthold
Department of Oral and Maxillofacial Surgery, University Hospital Bonn, Siegmund-Freud-Straße 25, 53127, Bonn, Northrhine-Westphalia, Germany.
Department of General and Visceral Surgery, St. Marienhospital Bonn, Robert-Koch-Straße 1, 53115, Bonn, Northrhine-Westphalia, Germany.
Int J Colorectal Dis. 2018 May;33(5):531-539. doi: 10.1007/s00384-018-3022-x. Epub 2018 Mar 13.
This study set out to compare the in-hospital outcomes of early elective and elective laparoscopic sigmoidectomy due to diverticulitis.
We examined the data for 378 diverticulitis patients who received an elective laparoscopic sigmoid resection between 2008 and 2012. We divided the patients into two groups: elective (group A, n = 278) and early elective (group B, n = 100). Patients in group A received surgery during the inflammation-free interval, and those in group B immediately after treating the attack with IV antibiotics for a mean period of 8 days (IQR = 3).
Overall mortality was 0%. The mean operation duration was the same in both groups being 77.5 and 80 min respectively. There was no significant difference in the outcomes between the two groups, measured using the Clavien-Dindo classification of surgical complication (CCSC; p = 0.992). A revision due to complications was necessary in 16 cases (group A) and six cases (group B) (p = 0.820). The conversion rate to open surgery was low (six individuals in group A, vs. four in group B; p = 0.331). Patients in group B suffered significantly fewer diverticulitis attacks (three in group A, vs. two in group B; p = 0.026).
Our study showed no difference in outcome between elective and early elective cases. Operation durations were optimal in both cases and were 50% shorter than those recorded in the literature. An early elective operation represents a good treatment option, especially for patients suffering from complicated diverticulitis.
本研究旨在比较因憩室炎行早期择期和择期腹腔镜乙状结肠切除术的院内结局。
我们检查了2008年至2012年间接受择期腹腔镜乙状结肠切除术的378例憩室炎患者的数据。我们将患者分为两组：择期手术组（A组，n = 278）和早期择期手术组（B组，n = 100）。A组患者在炎症消退期接受手术，B组患者在用静脉抗生素平均治疗8天（四分位间距 = 3天）的发作期后立即接受手术。
总死亡率为0%。两组的平均手术时间相同，分别为77.5分钟和80分钟。使用Clavien-Dindo手术并发症分类（CCSC）测量，两组的结局无显著差异（p = 0.992）。A组有16例（B组有6例）因并发症需要进行再次手术（p = 0.820）。转为开放手术的发生率较低（A组6例，B组4例；p = 0.331）。B组患者的憩室炎发作明显较少（A组3例，B组2例；p = 0.026）。
我们的研究表明，择期和早期择期病例的结局没有差异。两种情况下的手术时间均最佳，比文献报道的时间短50%。早期择期手术是一种很好的治疗选择，特别是对于患有复杂性憩室炎的患者。
