Coakley Kathleen M, Davis Bradley R, Kasten Kevin R
Department of Surgery, Carolinas HealthCare System, Charlotte, North Carolina.
Clin Colon Rectal Surg. 2021 Mar;34(2):96-103. doi: 10.1055/s-0040-1716701. Epub 2020 Oct 21.
The modern management of colonic diverticular disease involves grouping patients into uncomplicated or complicated diverticulitis, after which the correct treatment paradigm is instituted. Recent controversies suggest overlap in management strategies between these two groups. While most reports still support surgical intervention for the treatment of complicated diverticular disease, more data are forthcoming suggesting complicated diverticulitis does not merit surgical resection in all scenarios. Given the significant risk for complication in surgery for diverticulitis, careful attention should be paid to patient and procedure selection. Here, we define complicated diverticulitis, discuss options for surgical intervention, and explain strategies for avoiding operative pitfalls that result in early and late postoperative complications.
现代结肠憩室病的管理包括将患者分为非复杂性或复杂性憩室炎，然后制定正确的治疗方案。最近的争议表明这两组之间的管理策略存在重叠。虽然大多数报告仍支持手术干预治疗复杂性憩室病，但越来越多的数据表明，在所有情况下，复杂性憩室炎并不都值得进行手术切除。鉴于憩室炎手术并发症风险较高，应仔细关注患者和手术选择。在此，我们定义复杂性憩室炎，讨论手术干预的选择，并解释避免导致术后早期和晚期并发症的手术陷阱的策略。
