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Surgical management of acute sigmoid diverticulitis.
Ann Ital Chir 2008 Sep-Oct; 79(5):311-20AI

Abstract

INTRODUCTION

Medical therapy is usually indicated for uncomplicated diverticulitis. Indications for surgery include recurrent attacks and complications of the disease. This study describes our experience in the surgical treatment of acute sigmoid diverticulitis.

METHODS

Between 2001 and 2006, 82 patients were operated for acute sigmoid diverticulitis.

RESULTS

The indications for surgery included recurrent diverticulitis (7 patients), Hinchey stages I or II (28 patients), Hinchey stages III or IV (34 patients), diverticular colonic stricture (8 patients), diverticular bleeding (3 patients) and colovescical fistulae (2 patients). Of our 82 patients with surgical treatment, 77 with acute inflammatory complications have been analysed. 43 of them (55.9%) were treated by the Hartmann's procedures, and 34 (44.1%) by primary colonic resection-anastomosis. Hartmann's operation was performed in 5 of 28 (17.9%) patients with Hinchey stages I or II with elevated comorbidity, in all 34 patients with Hinchey stages III or IV and in 4 of 8 patients (50%) with diverticular stricture. Primary colonic resections-anastomosis was performed in all 7 patients with recurrence of diverticulitis, in 23 of 28 patients (82.1%) with Hinchey stages I or II, and in 4 of 8 (50%) patients with diverticular stricture. The overall perioperative mortality rate was 7.8%. The overall perioperative morbidity rate was 18.2%.

CONCLUSION

According to the data obtained from our experience and considering the current literature on the topic, the primary colonic resection-anastomosis represents the first choice intervention in stages I-II. The Hartmann's procedure confirms its effectiveness in stages III-IV.

Authors+Show Affiliations

Unit of Emergency Surgery, Umberto I Hospital, ASL Salerno 1, Nocera Inferiore, Salerno, Italy. mauriziomastrorilli@fastwebnet.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19149358

Citation

Mastrorilli, Maurizio, et al. "Surgical Management of Acute Sigmoid Diverticulitis." Annali Italiani Di Chirurgia, vol. 79, no. 5, 2008, pp. 311-20.
Mastrorilli M, Mastrorilli G, Martini A, et al. Surgical management of acute sigmoid diverticulitis. Ann Ital Chir. 2008;79(5):311-20.
Mastrorilli, M., Mastrorilli, G., Martini, A., Santo, C., & Maresca, M. (2008). Surgical management of acute sigmoid diverticulitis. Annali Italiani Di Chirurgia, 79(5), pp. 311-20.
Mastrorilli M, et al. Surgical Management of Acute Sigmoid Diverticulitis. Ann Ital Chir. 2008;79(5):311-20. PubMed PMID: 19149358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical management of acute sigmoid diverticulitis. AU - Mastrorilli,Maurizio, AU - Mastrorilli,Giovanni, AU - Martini,Angelo, AU - Santo,Carlo, AU - Maresca,Marcella, PY - 2009/1/20/entrez PY - 2009/1/20/pubmed PY - 2009/2/21/medline SP - 311 EP - 20 JF - Annali italiani di chirurgia JO - Ann Ital Chir VL - 79 IS - 5 N2 - INTRODUCTION: Medical therapy is usually indicated for uncomplicated diverticulitis. Indications for surgery include recurrent attacks and complications of the disease. This study describes our experience in the surgical treatment of acute sigmoid diverticulitis. METHODS: Between 2001 and 2006, 82 patients were operated for acute sigmoid diverticulitis. RESULTS: The indications for surgery included recurrent diverticulitis (7 patients), Hinchey stages I or II (28 patients), Hinchey stages III or IV (34 patients), diverticular colonic stricture (8 patients), diverticular bleeding (3 patients) and colovescical fistulae (2 patients). Of our 82 patients with surgical treatment, 77 with acute inflammatory complications have been analysed. 43 of them (55.9%) were treated by the Hartmann's procedures, and 34 (44.1%) by primary colonic resection-anastomosis. Hartmann's operation was performed in 5 of 28 (17.9%) patients with Hinchey stages I or II with elevated comorbidity, in all 34 patients with Hinchey stages III or IV and in 4 of 8 patients (50%) with diverticular stricture. Primary colonic resections-anastomosis was performed in all 7 patients with recurrence of diverticulitis, in 23 of 28 patients (82.1%) with Hinchey stages I or II, and in 4 of 8 (50%) patients with diverticular stricture. The overall perioperative mortality rate was 7.8%. The overall perioperative morbidity rate was 18.2%. CONCLUSION: According to the data obtained from our experience and considering the current literature on the topic, the primary colonic resection-anastomosis represents the first choice intervention in stages I-II. The Hartmann's procedure confirms its effectiveness in stages III-IV. SN - 0003-469X UR - https://www.unboundmedicine.com/medline/citation/19149358/Surgical_management_of_acute_sigmoid_diverticulitis_ L2 - http://www.diseaseinfosearch.org/result/9681 DB - PRIME DP - Unbound Medicine ER -