Colorectal Unit, Department of Surgery, and Centre for Clinical Research Uppsala University, Västmanlands Hospital Västerås, 72189, Västerås, Sweden.
Br J Surg. 2019 Oct;106(11):1542-1548. doi: 10.1002/bjs.11239. Epub 2019 Aug 6.
The aim of this study was to assess the long-term results in patients with uncomplicated diverticulitis who had participated in the Antibiotics in Acute Uncomplicated Diverticulitis (AVOD) RCT, which randomized patients with CT-verified left-sided acute uncomplicated diverticulitis to management without or with antibiotics.
The medical records of patients who had participated in the AVOD trial were reviewed for long-term results such as recurrences, complications and surgery. Quality-of-life questionnaires (EQ-5D™) were sent to patients, who were also contacted by telephone. Descriptive statistics were used for the analysis of clinical outcomes.
A total of 556 of the 623 patients (89·2 per cent) were followed up for a median of 11 years. There were no differences between the no-antibiotic and antibiotic group in recurrences (both 31·3 per cent; P = 0·986), complications (4·4 versus 5·0 per cent; P = 0·737), surgery for diverticulitis (6·2 versus 7·1 per cent; P = 0·719) or colorectal cancer (0·4 versus 2·1 per cent; P = 0·061). The response rate for the EQ-5D™ was 52·8 versus 45·2 per cent respectively (P = 0·030), and no differences were found between the two groups in any of the measured dimensions.
Antibiotic avoidance for uncomplicated diverticulitis is safe in the long term.
本研究旨在评估参加急性单纯性憩室炎抗生素（AVOD）RCT 的无并发症憩室炎患者的长期结果，该 RCT 将经 CT 证实的左侧急性单纯性憩室炎患者随机分为不使用或使用抗生素治疗。
对参加 AVOD 试验的患者的病历进行了回顾，以评估长期结果，如复发、并发症和手术。向患者发送了生活质量问卷（EQ-5D™），并通过电话与患者联系。采用描述性统计方法分析临床结果。
共有 623 名患者中的 556 名（89.2%）接受了中位数为 11 年的随访。在无抗生素组和抗生素组之间，复发率（分别为 31.3%和 31.3%；P=0.986）、并发症（4.4%和 5.0%；P=0.737）、因憩室炎而行手术（6.2%和 7.1%；P=0.719）或结直肠癌（0.4%和 2.1%；P=0.061）无差异。EQ-5D™的应答率分别为 52.8%和 45.2%（P=0.030），两组在测量的任何维度均无差异。
对于单纯性憩室炎，避免使用抗生素在长期内是安全的。
