Division of Mayo Clinic Colon and Rectal Surgery, 200 First Street, SW, Rochester, MN 55905, USA; Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada.
Department of Surgery, McGill University, Montreal, Quebec, Canada; Department of Colorectal Surgery, Cleveland Clinic Florida, Ellen Leifer Shulman and Steven Shulman Digestive Disease Institute, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.
Adv Surg. 2024 Sep;58(1):87-106. doi: 10.1016/j.yasu.2024.04.017. Epub 2024 Jun 27.
Over the last few decades, our understanding of the pathophysiology and natural history of sigmoid diverticulitis has greatly improved. This knowledge has challenged many of the traditional principles in the management for diverticulitis, such as routine antibiotic administration in all cases, number-based recommendations for elective surgery, and the necessity for an end colostomy in emergency surgery. This review will cover the breadth of management for sigmoid diverticulitis, covering both uncomplicated and complicated disease as well as elective and emergent disease presentations. New and emerging concepts in management will be highlighted with a particular focus on level-1 data, when available.
在过去的几十年中,我们对乙状结肠憩室炎的病理生理学和自然史的理解有了很大的提高。这一认识对憩室炎治疗的许多传统原则提出了挑战,例如所有情况下常规使用抗生素、基于数字的择期手术推荐以及急诊手术中结肠造口术的必要性。本综述将涵盖乙状结肠憩室炎的广泛管理,包括简单和复杂疾病以及择期和紧急疾病表现。将重点介绍管理方面的新出现的概念,特别是在有可用的 1 级数据的情况下。