Farkouh E, Hellou G, Allard M, Atlas H
Can J Surg. 1982 May;25(3):314-6.
Primary resection is the treatment of choice for diverticulitis of the colon with perforation and generalized peritonitis. Although there has been controversy concerning the management of the bowel ends after resection, for the last 20 years immediate anastomosis has been gaining increasing support. Between 1970 and 1981, at the Hôpital du Sacré-Coeur in Montreal, 15 patients having diverticulitis with perforation and diffuse spreading peritonitis who fulfilled specific criteria were treated by primary resection of the perforated segment of bowel and immediate anastomosis. The criteria for operation were : (a) the bowel must not be distended; (b) the bowel should be empty of feces; (c) edema of bowel wall at the resection site must be minimal; (d) the distal segment of colon should be above the peritoneal reflection; (e) there should be no fecal contamination; (f) the patient's general condition should be reasonably good. If these criteria were met, the procedure was safe and gave satisfactory results. In the authors' series, postoperative hospital stay was reduced considerably (it averaged 11 days). There was one anastomotic pulmonary edema.
对于伴有穿孔和弥漫性腹膜炎的结肠憩室炎，一期切除是首选的治疗方法。尽管对于切除术后肠管断端的处理一直存在争议，但在过去20年中，一期吻合越来越受到支持。1970年至1981年期间，在蒙特利尔的圣心医院，15例符合特定标准的伴有穿孔和弥漫性腹膜炎的憩室炎患者接受了肠穿孔段的一期切除和一期吻合治疗。手术标准为：（a）肠管不得扩张；（b）肠管内应无粪便；（c）切除部位肠壁的水肿必须最小；（d）结肠远端应在腹膜反折上方；（e）不应有粪便污染；（f）患者的一般状况应相当良好。如果符合这些标准，该手术是安全的，并能取得满意的效果。在作者的系列病例中，术后住院时间显著缩短（平均为11天）。有一例吻合口肺水肿。
