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[Therapy of choice in complicated diverticulitis?]
R Zengaffinen1, T Clerici, J Lange
1Klinik für Chirurgie, Kantonsspital St. Gallen.
Helvetica Chirurgica Acta
|July 1, 1994
Summary
Primary resection with anastomosis is the preferred treatment for complicated diverticular disease, significantly reducing complications, mortality, and hospital stays compared to older methods.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Colorectal Surgery
Background:
- Complicated diverticular disease presents significant treatment challenges.
- Traditional surgical approaches often involved multiple stages and colostomy formation.
- Evaluating operative procedures for complicated diverticular disease is crucial for improving patient outcomes.
Purpose of the Study:
- To compare the outcomes of primary resection with primary anastomosis versus traditional methods for complicated diverticular disease.
- To analyze postoperative morbidity, lethality, stoma rates, and length of stay.
- To determine the optimal surgical strategy for complicated diverticular disease.
Main Methods:
- Retrospective and prospective analysis of 79 patients treated between 1988 and 1992.
- Comparison of two groups: Group A (retrospective, n=42) and Group B (prospective, n=37).
- Focus on primary resection with primary anastomosis in Group B.
Main Results:
- Complication rates decreased from 35.7% to 29.7% in Group B.
- Lethality rates significantly reduced from 9.5% to 2.7% in Group B.
- Stoma formation decreased from 22 in Group A to 4 in Group B; mean hospital stay reduced from 31 to 22 days.
Conclusions:
- Primary resection with primary anastomosis is associated with improved outcomes in complicated diverticular disease.
- This approach leads to lower morbidity, mortality, and reduced need for stomas.
- The study supports primary resection with anastomosis as the preferred therapy for complicated diverticular disease.