Konyukova A K, Mikhaleva L M, Kozlova M A, Areshidze D A, Pechnikova V V, Shapovaliants S G, Mikhalev A I, Bolikhov K V, Shulaev A V
Avtsyn Research Institute of Human Morphology of Petrovsky National Research Centre of Surgery, Moscow, Russia.
Savelyeva Moscow City Clinical Hospital No. 31, Moscow, Russia.
Arkh Patol. 2024;86(4):13-22. doi: 10.17116/patol20248604113.
The high incidence of colonic diverticular disease (DD) in the general population is a serious public health problem. According to statistics, DD is among the top five most common colorectal diseases. Complicated course of DD is observed in 12-15% of patients, and in 10.7% of cases can lead to death. Algorithms and recommendations for predicting the complicated course of DD for further prevention have not been developed.
Comparative analysis of clinical data and structural characteristics of the colonic muscular tissue in patients with different course of DD and without colonic diverticula to identify morphological predictors of a complicated DD.
A comparative analysis of clinical data, pathomorphological and ultrastructural changes of the colonic musculature in the surgical material from 68 patients undergoing left-sided hemicolectomy was carried out.
The operative material of 37 patients with complicated course of DD, 19 with uncomplicated course of DD and 12 without diverticula was analyzed. In men, this disease occurs at a younger age than in women (Median age of men 49 (39.5; 61) years, women 66.5 (58; 81) years; =178, <0.001). It was shown that the area occupied by connective tissue fibres in the colonic musculature in patients with a complicated DD was 5 times greater (15%) than in observations with an uncomplicated DD (3%) and 50 times greater than in cases without colonic diverticula (0.3%; <0.001).
The present study demonstrates age- and sex-specific features of DD, as well as significant differences in the prevalence of fibrosis of the colonic musculature, which can be considered as a potential predictor of a complicated course of DD.
结肠憩室病（DD）在普通人群中的高发病率是一个严重的公共卫生问题。据统计，DD是最常见的五种结直肠疾病之一。12% - 15%的患者会出现DD的复杂病程，10.7%的病例可导致死亡。尚未制定出用于预测DD复杂病程以进行进一步预防的算法和建议。
对不同病程的DD患者和无结肠憩室患者的临床数据及结肠肌肉组织的结构特征进行比较分析，以确定复杂DD的形态学预测指标。
对68例行左侧半结肠切除术患者手术材料中的临床数据、结肠肌肉组织的病理形态学及超微结构变化进行了比较分析。
分析了37例DD复杂病程患者、19例DD非复杂病程患者和12例无憩室患者的手术材料。男性患此病的年龄比女性小（男性中位年龄49（39.5；61）岁，女性66.5（58；81）岁；=178，<0.001）。结果表明，复杂DD患者结肠肌肉组织中结缔组织纤维所占面积比非复杂DD患者（3%）大5倍（15%），比无结肠憩室患者（0.3%）大50倍（<0.001）。
本研究揭示了DD的年龄和性别特异性特征，以及结肠肌肉组织纤维化患病率的显著差异，这可被视为复杂DD病程的潜在预测指标。
