Department of Endocrine and Digestive Surgery, Sorbonne Université, Hospital Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
Department of Digestive Surgery, Université de Paris, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Tech Coloproctol. 2021 May;25(5):549-558. doi: 10.1007/s10151-021-02423-w. Epub 2021 Mar 3.
Diverticular disease is a common disorder. Several guidelines report on its optimal management. The aim of this study was to describe the evolution of the prevalence of this disease, the treatment strategies, and the mortality rate on a national level.
We conducted a retrospective study on prospective data using a nationwide database. All consecutive adult patients diagnosed with diverticular disease and admitted via the emergency department from 2009 to 2018 were included in the study. We performed a descriptive analysis for epidemiologic data, diagnosis, and treatment.
During the data collection period, 233,386 patients were included in the study. The number of admissions for emergent diverticular disease increased by 65.8%, from 16,754 in 2009 to 27,781 in 2018, for both uncomplicated and complicated diverticular disease. Among these patients, 19,350 (8.3%) were operated on. The rate of surgical treatment progressively decreased from 9.7% in 2009 to 7.6% in 2018. The three main interventions were Hartmann's procedure (HP, n = 9111, 47.1%), resection with primary anastomosis (RPA, n = 4335, 22.4%), and peritoneal lavage (PL, n = 4836, 25%). We observed a progressive annual increase in HPs (n = 716 in 2009 and n = 1055 in 2018) as well as a decline in PLs since 2015, while the number of RPAs remained stable.
Although admissions for emergent diverticular disease have increased during the study period, the rate of surgical treatment has decreased, suggesting an evolution toward more conservative management of this pathology.
憩室病是一种常见疾病。有几个指南报告了其最佳管理方法。本研究的目的是描述该病的患病率、治疗策略和全国范围内的死亡率演变。
我们使用全国性数据库对前瞻性数据进行了回顾性研究。所有 2009 年至 2018 年间因憩室病通过急诊科就诊的成年患者均纳入研究。我们对流行病学数据、诊断和治疗进行了描述性分析。
在数据收集期间，共有 233386 名患者纳入研究。复杂和单纯性憩室病的急诊憩室病入院人数增加了 65.8%，从 2009 年的 16754 例增加到 2018 年的 27781 例。这些患者中有 19350 例（8.3%）接受了手术治疗。手术治疗率从 2009 年的 9.7%逐渐下降到 2018 年的 7.6%。三种主要手术方式为：Hartmann 手术（HP，n=9111，47.1%）、直接吻合切除术（RPA，n=4335，22.4%）和腹腔灌洗术（PL，n=4836，25%）。我们观察到 HP 的年度增长率逐渐增加（2009 年为 716 例，2018 年为 1055 例），同时自 2015 年以来 PL 的数量有所下降，而 RPA 的数量保持稳定。
尽管在研究期间急诊憩室病的入院人数有所增加，但手术治疗率有所下降，表明对该病理的治疗方法趋于更保守。
