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Management of sigmoid diverticulitis: a retrospective study of 268 patients.
Hepatogastroenterology 2008 Nov-Dec; 55(88):2065-71H

Abstract

BACKGROUND/AIMS

The therapeutic management of acute diverticulitis has evolved over the last years in favour of an initial conservative approach with laparoscopy rather than a primary anastomosis. We studied the management of sigmoid diverticulitis in the Digestive Surgical Unit to assess it in comparison to actual practice.

METHODOLOGY

A retrospective review of patients admitted to our unit from January 1998 to June 2006 for diverticular disease. We divided the patients into 3 groups (Urgent Medical Group (UM), Urgent Surgical Group (US) and Scheduled Surgical Group (SS)), and analysed demographic data, the severity and recurrence of diverticulitis, pathology results, length of stay, morbidity and mortality.

RESULTS

The mean age was 60.5+/-14.9 years. The overall mortality was 3% (14.5% for the Acute Surgical Group and 0 % for the Elective Surgical Group); overall morbidity 38.4%; the incidence of neoplasm 4.8% in urgent colectomies and 0.9% in scheduled colectomies.

CONCLUSIONS

Based on our study and published reviews, we recommend elective colectomy after 2 recurrent episodes of acute diverticulitis, one episode of complicated acute diverticulitis managed conservatively, or if the patient is younger than 50 years-old. This approach would reduce the number of acute operations, which are associated with high morbidity and mortality.

Authors+Show Affiliations

Department of Digestive, Laparoscopic and Thoracic Surgery, C.H.U. Brugmann, U.L.B., Brussels, Belgium.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

19260478

Citation

Boudart, C, et al. "Management of Sigmoid Diverticulitis: a Retrospective Study of 268 Patients." Hepato-gastroenterology, vol. 55, no. 88, 2008, pp. 2065-71.
Boudart C, Simoens Ch, Thill V, et al. Management of sigmoid diverticulitis: a retrospective study of 268 patients. Hepatogastroenterology. 2008;55(88):2065-71.
Boudart, C., Simoens, C. h., Thill, V., Debergh, N., Smets, D., & Mendes da Costa, P. (2008). Management of sigmoid diverticulitis: a retrospective study of 268 patients. Hepato-gastroenterology, 55(88), pp. 2065-71.
Boudart C, et al. Management of Sigmoid Diverticulitis: a Retrospective Study of 268 Patients. Hepatogastroenterology. 2008;55(88):2065-71. PubMed PMID: 19260478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of sigmoid diverticulitis: a retrospective study of 268 patients. AU - Boudart,C, AU - Simoens,Ch, AU - Thill,V, AU - Debergh,N, AU - Smets,D, AU - Mendes da Costa,P, PY - 2009/3/6/entrez PY - 2009/3/6/pubmed PY - 2009/4/25/medline SP - 2065 EP - 71 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 55 IS - 88 N2 - BACKGROUND/AIMS: The therapeutic management of acute diverticulitis has evolved over the last years in favour of an initial conservative approach with laparoscopy rather than a primary anastomosis. We studied the management of sigmoid diverticulitis in the Digestive Surgical Unit to assess it in comparison to actual practice. METHODOLOGY: A retrospective review of patients admitted to our unit from January 1998 to June 2006 for diverticular disease. We divided the patients into 3 groups (Urgent Medical Group (UM), Urgent Surgical Group (US) and Scheduled Surgical Group (SS)), and analysed demographic data, the severity and recurrence of diverticulitis, pathology results, length of stay, morbidity and mortality. RESULTS: The mean age was 60.5+/-14.9 years. The overall mortality was 3% (14.5% for the Acute Surgical Group and 0 % for the Elective Surgical Group); overall morbidity 38.4%; the incidence of neoplasm 4.8% in urgent colectomies and 0.9% in scheduled colectomies. CONCLUSIONS: Based on our study and published reviews, we recommend elective colectomy after 2 recurrent episodes of acute diverticulitis, one episode of complicated acute diverticulitis managed conservatively, or if the patient is younger than 50 years-old. This approach would reduce the number of acute operations, which are associated with high morbidity and mortality. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/19260478/Management_of_sigmoid_diverticulitis:_a_retrospective_study_of_268_patients_ L2 - http://www.diseaseinfosearch.org/result/9681 DB - PRIME DP - Unbound Medicine ER -