[Primary delayed indication for single-step continence resection in 300 patients with acute colonic diverticulitis]

Since 1980, a total of 300 patients with colonic diverticulitis have undergone surgery. A vital indication forced us to do an emergency colostomy or Hartmann procedure in 22 cases. Except for 3 patients, the indication for resection was intentionally delayed by means of conservative treatment and a primary anastomosis was performed. Histological findings verified an inflammatory tumor, and abscess, a fistula or perforation in 50% and circumscript inflammation in 37%. The main complications were drainage problems (infection/retention of secretion, n = 18) and anastomosis insufficiency (n = 5), lethality was less than 2%. In general, we think that multistep surgery is not mandatory--even in advanced cases.