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One-stage sigmoid colon resection for perforated sigmoid diverticulitis (Hinchey stages III and IV).
World J Surg. 2006 Jun; 30(6):1027-32.WJ

Abstract

INTRODUCTION

Guidelines for the treatment of complicated sigmoid diverticulitis recommend Hartmann's procedure or anastomosis with protective colostomy for Hinchey stage III diverticulitis and Hartmann's procedure only for Hinchey stage IV diverticulitis. We evaluated the outcome of patients with perforated sigmoid diverticulitis Hinchey III/IV undergoing one-stage colon resection and primary anastomosis without protective colostomy.

METHODS

After implementation of a protocol to treat Hinchey III/IV diverticulitis with primary anastomosis without protective ileocolostomy, the patients' data were recorded prospectively between August 2001 and August 2003 and analyzed retrospectively from a computer-related database.

RESULTS

Of 41 patients, 34 (81%) underwent one-stage sigmoid resection and primary anastomosis, 3 of 41 patients (7%) underwent primary anatomosis with protective ileostomy, and 5 of 41 patients (12%) had a Hartmann's procedure. The mortality was 11% in patients undergoing primary anastomosis and 60% in patients with Hartmann's procedure. The relative risk of co-morbidity factors for lethal outcome after sigmoid resection was 6.94 for preceding operations, 3.75 for renal failure or renal transplantation, and 3.25 for immunosuppression.

CONCLUSIONS

One-stage sigmoid resection and primary anastomosis can be performed safely in nearly 90% of all patients with perforated sigmoid diverticulitis (Hinchey III/IV) by surgeons of different training levels. Patients with immunosuppression, chronic renal failure, liver cirrhosis, or previous organ transplantation or complex cardiovascular reconstructive procedures have a significantly increased risk of dying after sigmoid resection for perforated diverticulitis.

Authors+Show Affiliations

Clinic of General, Visceral, Vascular, and Pediatric Surgery, University Hospital of the Saarland, Kirrberger Strasse, D-66421 Homburg/Saar, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16736332

Citation

Richter, Sven, et al. "One-stage Sigmoid Colon Resection for Perforated Sigmoid Diverticulitis (Hinchey Stages III and IV)." World Journal of Surgery, vol. 30, no. 6, 2006, pp. 1027-32.
Richter S, Lindemann W, Kollmar O, et al. One-stage sigmoid colon resection for perforated sigmoid diverticulitis (Hinchey stages III and IV). World J Surg. 2006;30(6):1027-32.
Richter, S., Lindemann, W., Kollmar, O., Pistorius, G. A., Maurer, C. A., & Schilling, M. K. (2006). One-stage sigmoid colon resection for perforated sigmoid diverticulitis (Hinchey stages III and IV). World Journal of Surgery, 30(6), 1027-32.
Richter S, et al. One-stage Sigmoid Colon Resection for Perforated Sigmoid Diverticulitis (Hinchey Stages III and IV). World J Surg. 2006;30(6):1027-32. PubMed PMID: 16736332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - One-stage sigmoid colon resection for perforated sigmoid diverticulitis (Hinchey stages III and IV). AU - Richter,Sven, AU - Lindemann,Werner, AU - Kollmar,Otto, AU - Pistorius,Georg A, AU - Maurer,Christoph A, AU - Schilling,Martin K, PY - 2006/6/1/pubmed PY - 2006/12/9/medline PY - 2006/6/1/entrez SP - 1027 EP - 32 JF - World journal of surgery JO - World J Surg VL - 30 IS - 6 N2 - INTRODUCTION: Guidelines for the treatment of complicated sigmoid diverticulitis recommend Hartmann's procedure or anastomosis with protective colostomy for Hinchey stage III diverticulitis and Hartmann's procedure only for Hinchey stage IV diverticulitis. We evaluated the outcome of patients with perforated sigmoid diverticulitis Hinchey III/IV undergoing one-stage colon resection and primary anastomosis without protective colostomy. METHODS: After implementation of a protocol to treat Hinchey III/IV diverticulitis with primary anastomosis without protective ileocolostomy, the patients' data were recorded prospectively between August 2001 and August 2003 and analyzed retrospectively from a computer-related database. RESULTS: Of 41 patients, 34 (81%) underwent one-stage sigmoid resection and primary anastomosis, 3 of 41 patients (7%) underwent primary anatomosis with protective ileostomy, and 5 of 41 patients (12%) had a Hartmann's procedure. The mortality was 11% in patients undergoing primary anastomosis and 60% in patients with Hartmann's procedure. The relative risk of co-morbidity factors for lethal outcome after sigmoid resection was 6.94 for preceding operations, 3.75 for renal failure or renal transplantation, and 3.25 for immunosuppression. CONCLUSIONS: One-stage sigmoid resection and primary anastomosis can be performed safely in nearly 90% of all patients with perforated sigmoid diverticulitis (Hinchey III/IV) by surgeons of different training levels. Patients with immunosuppression, chronic renal failure, liver cirrhosis, or previous organ transplantation or complex cardiovascular reconstructive procedures have a significantly increased risk of dying after sigmoid resection for perforated diverticulitis. SN - 0364-2313 UR - https://www.unboundmedicine.com/medline/citation/16736332/One_stage_sigmoid_colon_resection_for_perforated_sigmoid_diverticulitis__Hinchey_stages_III_and_IV__ L2 - https://dx.doi.org/10.1007/s00268-005-0439-5 DB - PRIME DP - Unbound Medicine ER -