Colorectal Surgery Unit ASST Brianza, Desio Hospital, Desio, Italy.
University of Milan, Milan, Italy.
Int J Colorectal Dis. 2022 Oct;37(10):2149-2155. doi: 10.1007/s00384-022-04248-x. Epub 2022 Sep 1.
Elective sigmoid resection is proposed as a treatment for symptomatic diverticular disease for the possible improvement in quality of life achievable. Albeit encouraging results have been reported, recurrent diverticulitis is still a concern deeply affecting quality of life. The aim of this study is to determine the rate of recurrent diverticulitis after elective sigmoid resection and to look for possible perioperative risk factors.
Patients who underwent elective resection for DD with at least a 3-year follow-up were included. Postoperative recurrence was defined as left-sided or lower abdominal pain, with CT scan-confirmed findings of diverticulitis.
Twenty of 232 (8.6%) patients developed CT-proven recurrent diverticulitis after elective surgery. All the 20 recurrent diverticulitis were uncomplicated and did not need surgery. Eighty-five percent of the recurrences occurred in patients with a preoperative diagnosis of uncomplicated DD, 70% in patients who had at least 4 episodes of diverticulitis, and 70% in patients with a history of diverticulitis extended to the descending colon. Univariate analysis showed that recurrence was associated with diverticulitis of the sigmoid and of the descending colon (p = 0.04), with a preoperative diagnosis of IBS (p = 0.04) and with a longer than 5 years diverticular disease (p = 0.03). Multivariate analysis was not able to determine risks factors for recurrence.
Our study showed that patients with a preoperative diagnosis of IBS, diverticulitis involving the descending colon, and a long-lasting disease are more likely to have recurrent diverticulitis. However, these variables could not be assumed as risk factors.
择期行乙状结肠切除术被提议作为治疗有症状的憩室病的方法，以改善可能获得的生活质量。尽管已有令人鼓舞的结果报道，但憩室炎的复发仍然是一个严重影响生活质量的问题。本研究旨在确定择期乙状结肠切除术后憩室炎复发的发生率，并寻找可能的围手术期危险因素。
纳入至少随访 3 年且因 DD 行择期切除术的患者。术后复发定义为左侧或下腹痛，经 CT 扫描证实存在憩室炎。
232 例患者中，20 例（8.6%）术后经 CT 证实发生复发性憩室炎。所有 20 例复发性憩室炎均为单纯性，无需手术。85%的复发发生在术前诊断为单纯性 DD 的患者中，70%发生在至少有 4 次憩室炎发作的患者中，70%发生在憩室炎病史延伸至降结肠的患者中。单因素分析显示，复发与乙状结肠和降结肠的憩室炎（p=0.04）、术前诊断为 IBS（p=0.04）以及憩室病持续时间超过 5 年（p=0.03）相关。多因素分析未能确定复发的危险因素。
我们的研究表明，术前诊断为 IBS、累及降结肠的憩室炎以及疾病持续时间较长的患者更有可能发生复发性憩室炎。然而，这些变量不能被视为危险因素。
