Neale Jeffrey A
Colorectal Institute, Fort Myers, Florida.
Clin Colon Rectal Surg. 2018 Jul;31(4):236-242. doi: 10.1055/s-0037-1607962. Epub 2018 Jun 22.
Diverticulosis is a common condition that has increased in prevalence in industrialized countries over the past century. Estimates of developing diverticular disease in the United states range from 5% by 40 years of age up, to over 80% by age 80. It is estimated that approximately 20% of patients with diverticulosis develop diverticulitis over the course of their lifetime. Diverticular disease can be divided into simple and chronic diverticulitis with various sub categories. There are various instances and circumstances where elective resection is indicated for both complex and simple forms of this disease process. When planning surgery there are general preoperative considerations that are important to be reviewed prior to surgery. There are also more specific considerations depending on secondary problem attributed to diverticulitis, that is, fistula vs stricture. Today, treatment for elective resection includes open, laparoscopic and robotic surgery. Over the last several years we have moved away from open surgery to laparoscopic surgery for elective resection. With the advent of robotic surgery and introduction of 3D laparoscopic surgery the discussion of superiority, equivalence between these modalities, is and should remain an important discussion topic.
憩室病是一种常见病症,在过去一个世纪里,其在工业化国家的患病率有所上升。在美国,40岁及以上人群患憩室病的估计比例从5%到80岁以上人群的超过80%不等。据估计,约20%的憩室病患者在其一生中会发展为憩室炎。憩室病可分为单纯性和慢性憩室炎,并具有各种亚类。对于这种疾病过程的复杂和简单形式,在多种情况和情形下都需要进行择期切除。在计划手术时,术前有一些一般注意事项,在手术前进行审查很重要。此外,根据憩室炎导致的继发问题,即瘘管与狭窄,还有更具体的注意事项。如今,择期切除的治疗方法包括开放手术、腹腔镜手术和机器人手术。在过去几年里,我们已从开放手术转向腹腔镜手术进行择期切除。随着机器人手术的出现以及3D腹腔镜手术的引入,关于这些手术方式的优越性、等效性的讨论过去是、并且应该仍然是一个重要的讨论话题。