Division of Colon and Rectal Surgery, Department of Surgery, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
Division of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
Int J Colorectal Dis. 2020 Sep;35(9):1711-1718. doi: 10.1007/s00384-020-03639-2. Epub 2020 May 27.
The aim of this study was to analyze clinical outcomes after surgical and/or conservative management of patients with colonic diverticulitis.
Between January 2001 and November 2018, data for 1175 patients (right (Rt.) side: n = 1037, left (Lt.) side: n = 138) who underwent conservative management (n = 987) and surgical management (n = 188) for colonic diverticulitis were retrieved from a retrospective database. The Rt. sided was defined up to the proximal two-thirds of the transverse colon and Lt. sided was defined from the distal one-third of the transverse colon.
The overall incidence of colonic diverticulitis is gradually increasing. The mean age of all patients was 43.2 ± 17 and was significantly higher in patients with Lt.-sided (57.0 ± 15.7) than with Rt.-sided (41.4 ± 13.4) diverticulitis (p = 0.001). The most common lesion site was cecum (71.7%, n = 843). First-time attacks were the most common (91.0%, n = 1069). The surgical rate was 12.2% on the right. sided and 44.9% on the left sided (p < 0.005). The mean age, age distribution, BMI, open surgery rate, stoma formation rate, and Hinchey types III and IV rate were significantly higher in Lt. sided than in Rt. sided (p < 0.005). Older age, higher BMI (≥ 25), and Hinchey types III and IV were significantly associated with surgical risk factors of diverticulitis (p < 0.005).
Base on present study, Lt.-sided colonic diverticulitis tends to be more severe than Rt. sided, and surgery is more often required. In addition, colonic diverticulitis that requires surgery seems to be older and more obese on Lt. sided.
本研究旨在分析结肠憩室炎患者经手术和/或保守治疗后的临床结局。
本研究回顾性分析了 2001 年 1 月至 2018 年 11 月间 1175 例接受保守治疗（n=987）和手术治疗（n=188）的结肠憩室炎患者的数据，其中右侧（右）憩室炎 1037 例，左侧（左）憩室炎 138 例。右侧定义为横结肠近端的前 2/3，左侧定义为横结肠远端的后 1/3。
结肠憩室炎的总体发病率呈逐渐上升趋势。所有患者的平均年龄为 43.2±17 岁，左憩室炎患者的平均年龄（57.0±15.7）显著高于右憩室炎患者（41.4±13.4）（p=0.001）。最常见的病变部位是盲肠（71.7%，n=843）。首次发作最为常见（91.0%，n=1069）。右侧手术率为 12.2%，左侧手术率为 44.9%（p<0.005）。左憩室炎患者的平均年龄、年龄分布、BMI、开放性手术率、造口形成率、Hinchey Ⅲ型和Ⅳ型的比例显著高于右憩室炎患者（p<0.005）。高龄、BMI 较高（≥25）和 Hinchey Ⅲ型和Ⅳ型与憩室炎的手术危险因素显著相关（p<0.005）。
基于本研究，左结肠憩室炎的严重程度倾向于比右结肠憩室炎更严重，需要手术治疗的情况更为常见。此外，需要手术治疗的结肠憩室炎在左侧似乎更常见于老年和肥胖患者。
