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[Complicated colonic diverticulosis. Changes in treatment and results over 22 years].
Presse Med. 1994 May 14; 23(18):834-8.PM

Abstract

OBJECTIVES

The aim of this study was to analyse the clinical course, surgical strategy and results in patients with complicated colonic diverticular disease.

METHODS

We retrospectively compared two groups of patients who underwent surgery for complicated colonic diverticulosis from 1970 to 1984 (Group A, n = 94, mean age 60 years, 49 males, 45 females) and from 1985 to 1992 (Group B, n = 76, mean age 63.5, 32 males, 44 females).

RESULTS

Patients in the two groups were comparable; only the rate of peritonitis (20 vs 8%) was different (p < 0.05). The most frequent operations in Group A were colostomy-drainage (43%) and Hartman's procedure (26%) in emergency situations and resection with immediate anastomosis (63%) or resection-anastomosis with diverting stomy (19%) in elective cases. In Group B, surgical strategy led to a different pattern of operations, 4 and 56% in emergency, and 94 and 2% in elective surgery, respectively. Overall mortality was 11%, with 17% and 4% in Groups A and B respectively (p < 0.01). This major drop in mortality was particularly important in emergency cases (31 vs 4%; p < 0.02). Morbidity in emergency surgery fell from 21 to 4% (P < 0.0006). Interrupting the use of colostomy-drainage was a major factor in reducing mortality followed by a sharp fall in mortality after Hartmann's procedure (28.5 vs 0%).

CONCLUSION

The marked improvement in results between the two groups was mainly due to preferring resections of pathological colonic segments over colostomy-drainage.

Authors+Show Affiliations

Service de Chirurgie Générale et Digestive, Hôpital de Hautepierre, Strasbourg.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

7937603

Citation

Rohr, S, et al. "[Complicated Colonic Diverticulosis. Changes in Treatment and Results Over 22 Years]." Presse Medicale (Paris, France : 1983), vol. 23, no. 18, 1994, pp. 834-8.
Rohr S, Thiry CL, Sadok H, et al. [Complicated colonic diverticulosis. Changes in treatment and results over 22 years]. Presse Med. 1994;23(18):834-8.
Rohr, S., Thiry, C. L., Sadok, H., de Manzini, N., Hollender, L. F., & Meyer, C. (1994). [Complicated colonic diverticulosis. Changes in treatment and results over 22 years]. Presse Medicale (Paris, France : 1983), 23(18), 834-8.
Rohr S, et al. [Complicated Colonic Diverticulosis. Changes in Treatment and Results Over 22 Years]. Presse Med. 1994 May 14;23(18):834-8. PubMed PMID: 7937603.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Complicated colonic diverticulosis. Changes in treatment and results over 22 years]. AU - Rohr,S, AU - Thiry,C L, AU - Sadok,H, AU - de Manzini,N, AU - Hollender,L F, AU - Meyer,C, PY - 1994/5/14/pubmed PY - 1994/5/14/medline PY - 1994/5/14/entrez SP - 834 EP - 8 JF - Presse medicale (Paris, France : 1983) JO - Presse Med VL - 23 IS - 18 N2 - OBJECTIVES: The aim of this study was to analyse the clinical course, surgical strategy and results in patients with complicated colonic diverticular disease. METHODS: We retrospectively compared two groups of patients who underwent surgery for complicated colonic diverticulosis from 1970 to 1984 (Group A, n = 94, mean age 60 years, 49 males, 45 females) and from 1985 to 1992 (Group B, n = 76, mean age 63.5, 32 males, 44 females). RESULTS: Patients in the two groups were comparable; only the rate of peritonitis (20 vs 8%) was different (p < 0.05). The most frequent operations in Group A were colostomy-drainage (43%) and Hartman's procedure (26%) in emergency situations and resection with immediate anastomosis (63%) or resection-anastomosis with diverting stomy (19%) in elective cases. In Group B, surgical strategy led to a different pattern of operations, 4 and 56% in emergency, and 94 and 2% in elective surgery, respectively. Overall mortality was 11%, with 17% and 4% in Groups A and B respectively (p < 0.01). This major drop in mortality was particularly important in emergency cases (31 vs 4%; p < 0.02). Morbidity in emergency surgery fell from 21 to 4% (P < 0.0006). Interrupting the use of colostomy-drainage was a major factor in reducing mortality followed by a sharp fall in mortality after Hartmann's procedure (28.5 vs 0%). CONCLUSION: The marked improvement in results between the two groups was mainly due to preferring resections of pathological colonic segments over colostomy-drainage. SN - 0755-4982 UR - https://www.unboundmedicine.com/medline/citation/7937603/[Complicated_colonic_diverticulosis__Changes_in_treatment_and_results_over_22_years]_ L2 - https://medlineplus.gov/diverticulosisanddiverticulitis.html DB - PRIME DP - Unbound Medicine ER -