Zengaffinen R, Clerici T, Lange J
Klinik für Chirurgie, Kantonsspital St. Gallen.
Helv Chir Acta. 1994 Jul;60(5):713-6.
Between 1988 and 1992 we treated in our hospital 79 patients with a complicated diverticular disease. We analysed and compared two groups (group A 42 cases January 1988 to February 1991/retrospectively, group B 37 cases March 1991 to December 1992/prospectively). We studied our operative procedure in respect to the postoperative morbidity and lethality, the number of performed and persistent stomata and the mean length of stay. The complications of diverticular disease in both groups were similar. Since March 1991 we performed primary resection with primary anastomosis in 89% of the patients, three-stage resection or primary resection with an anastomosis and a proximal colostomy was no more done. The Hartmann procedure was rarely chosen (only in 4 of 37 patients). In spite of forcing the primary resection with a primary anastomosis in group B, the complication rate (local and general) decreased from 35.7% to 29.7%, the lethality rate from 9.5% to 2.7%. The number of performed stomata showed a great difference with 22 in group A against 4 in group B. The mean length of stay was 31 versus 22 days. Therefore we consider primary resection with an anastomosis for the best therapy in complicated diverticular disease.
1988年至1992年间，我院收治了79例复杂性憩室病患者。我们分析并比较了两组（A组42例，1988年1月至1991年2月/回顾性研究；B组37例，1991年3月至1992年12月/前瞻性研究）。我们研究了手术操作在术后发病率和死亡率、造口施行和保留数量以及平均住院时间方面的情况。两组憩室病的并发症相似。自1991年3月起，我们对89%的患者进行了一期切除并一期吻合，不再进行三期切除或一期切除加吻合及近端结肠造口术。很少选择Hartmann手术（37例患者中仅4例）。尽管在B组强行采用一期切除并一期吻合，但并发症发生率（局部和全身）从35.7%降至29.7%，死亡率从9.5%降至2.7%。造口施行数量差异很大，A组为22个，B组为4个。平均住院时间分别为31天和22天。因此，我们认为一期切除并吻合是治疗复杂性憩室病的最佳方法。
