经皮引流治疗 Hinchey Ib 和 II 型伴脓肿的急性憩室炎可改善预后。
Percutaneous drainage for hinchey Ib and II acute diverticulitis with abscess improves outcomes.
作者信息
Rosen David R, Pott Emily G, Cologne Kyle G, Lee Sang W, Ault Glenn T, Grabo Daniel J, Clark Damon H, Strumwasser Aaron M
机构信息
Division of Trauma and Acute Care Surgery, USC Department of Surgery, Los Angeles County University of Southern California Medical Center, Los Angeles, CA, USA;Division of Colon and Rectal Surgery, USC Department of Surgery, Los Angeles County University of Southern California Medical Center, Los Angeles, CA, USA.
Division of Trauma and Acute Care Surgery, USC Department of Surgery, Los Angeles County University of Southern California Medical Center, Los Angeles, CA, USA.
出版信息
Turk J Gastroenterol. 2019 Nov;30(11):976-983. doi: 10.5152/tjg.2019.18602.
BACKGROUND/AIMS: The role of percutaneous drainage in Hinchey Ib and II diverticulitis is controversial. The aim of the present study was to clarify the indications for percutaneous drainage in such circumstances.
MATERIALS AND METHODS
This was a single-center retrospective review at an academic tertiary care hospital. All Hinchey Ib and II diverticulitis cases admitted from 2012 to 2014 were considered.
RESULTS
Overall, 104 (78%) patients underwent successful conservative treatment, whereas 30 (22%) patients underwent surgery during admission. During the index admission, abscess drainage was performed in 21 patients, of which 19 patients were successfully managed without surgery on the index admission and two patients ultimately required surgery. Elective versus same-admission surgery resulted in an increase use of laparoscopy (p=0.01), higher rate of restoration of gastrointestinal continuity with the index operation (p=0.04), and lower rate of diverting stoma formation (p<0.01).
CONCLUSION
Percutaneous drainage may diminish the need for emergent surgery for Hinchey Ib and II diverticulitis. Elective surgery following conservative management increases the use of laparoscopy and decreases the rates of stoma formation.
背景/目的：经皮引流在辛奇伊b型和II型憩室炎中的作用存在争议。本研究的目的是明确在这种情况下经皮引流的指征。
材料与方法
这是一项在学术性三级护理医院进行的单中心回顾性研究。纳入了2012年至2014年收治的所有辛奇伊b型和II型憩室炎病例。
结果
总体而言，104例（78%）患者接受了成功的保守治疗，而30例（22%）患者在住院期间接受了手术。在初次住院期间，21例患者进行了脓肿引流，其中19例患者在初次住院时未进行手术而成功治愈，2例患者最终需要手术。择期手术与同期手术相比，腹腔镜的使用增加（p = 0.01），初次手术时胃肠道连续性恢复率更高（p = 0.04），造口形成率更低（p < 0.01）。
结论
经皮引流可能减少辛奇伊b型和II型憩室炎急诊手术的需求。保守治疗后的择期手术增加了腹腔镜的使用并降低了造口形成率。
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