Zinzindohoué F, Vaillant J C, Faucheron J L, Parc R
Centre de Chirurgie Digestive, Hôpital Saint-Antoine, Paris.
Gastroenterol Clin Biol. 1998 Mar;22(3):286-9.
The appraisal of morbidity and mortality for one stage elective colectomy for complicated diverticulosis is difficult and often overestimated, due to the rarity of reports addressing this question. Our results for 100 patients on a recent 30 month period were studied retrospectively.
One hundred patients were electively operated in a one-stage procedure for complicated diverticulosis in a single institution from January 1993 to June 1995. There were 66 females and 34 males (range: 31-81 years) with a mean age of 61 years. Main indications for surgery were repeated attacks (34 patients), chronic inflammatory mass (26 patients) and stenosis (22 patients). Seventy-eight patients had already been admitted for diverticulitis prior to surgery. There were 13 surgeons including 6 seniors and 7 fellows.
There was no mortality. Morbidity was 14% surgical and medical complications accounting for 8% and 6% respectively. One patient had an anastomotic fistula treated conservatively and another patient was reoperated on for early postoperative occlusion There was no perioperative bleeding requiring transfusion. There were no surgical trauma of spleen or uretera. Mean hospital stay was 10 days.
This study of a collective surgical experience demonstrates that elective one stage left colectomy for benign disease is safe, without mortality and with low morbidity.
由于针对这一问题的报告较少,对复杂性憩室病一期择期结肠切除术的发病率和死亡率评估较为困难且往往被高估。我们回顾性研究了近期30个月内100例患者的结果。
1993年1月至1995年6月,在一家机构对100例复杂性憩室病患者进行了一期择期手术。其中女性66例,男性34例(年龄范围:31 - 81岁),平均年龄61岁。手术的主要指征为反复发作者(34例)、慢性炎性包块(26例)和狭窄(22例)。78例患者在手术前已因憩室炎入院。共有13名外科医生,其中6名资深医生和7名住院医生。
无死亡病例。发病率为14%,手术并发症和内科并发症分别占8%和6%。1例患者出现吻合口瘘,经保守治疗;另1例患者因术后早期梗阻接受再次手术。无围手术期出血需要输血。无脾脏或输尿管手术损伤。平均住院时间为10天。
这项集体手术经验研究表明,良性疾病的择期一期左半结肠切除术是安全的,无死亡且发病率低。