Hyoung-Chul Park1, Bong Hwa Lee. 1. Department of Surgery, Hallym University College of Medicine, Anyang 431-070, South Korea. greatpa1@hallym.or.kr
Abstract
AIM: To compare the recurrence rate following initial antibiotic management to that following laparoscopic treatment for suspected uncomplicated cecal diverticulitis. METHODS: We examined the records of 132 patients who were diagnosed with uncomplicated cecal diverticulitis and a first attack during an 8-year period. The diagnosis of uncomplicated diverticulitis was made based on imaging findings, such as inflamed diverticulum or a phlegmon with cecal wall thickening. Concurrent appendiceal dilatation from 8 to 12 mm was observed in 36 patients (27%). One hundred and two patients were treated initially with antibiotics only, whereas 30 underwent laparoscopic treatment, including partial cecectomy (n = 8) or appendectomy with diverticulectomy (n = 9) or appendectomy alone (n = 13). We compared clinical outcomes in both groups over a median follow-up period of 46 mo. RESULTS: All patients were successfully treated with initial therapy. Of the 102 patients who initially received only antibiotic treatment, 6 (6%) had a recurrence (3 in the cecum and 3 in the ascending colon or transverse colon) during the follow-up period. Five of these patients were managed with repeated antibiotic treatment and 1 underwent ileocolic resection for perforation. Of the 30 patients treated by the laparoscopic approach, 2 (7%) had a recurrence (ascending colon) which was treated with antibiotics. CONCLUSION: Initial antibiotic management for suspected uncomplicated cecal diverticulitis showed comparable efficacy to laparoscopic treatment in the prevention of recurrence.
AIM: To compare the recurrence rate following initial antibiotic management to that following laparoscopic treatment for suspected uncomplicated cecal diverticulitis. METHODS: We examined the records of 132 patients who were diagnosed with uncomplicated cecal diverticulitis and a first attack during an 8-year period. The diagnosis of uncomplicated diverticulitis was made based on imaging findings, such as inflamed diverticulum or a phlegmon with cecal wall thickening. Concurrent appendiceal dilatation from 8 to 12 mm was observed in 36 patients (27%). One hundred and two patients were treated initially with antibiotics only, whereas 30 underwent laparoscopic treatment, including partial cecectomy (n = 8) or appendectomy with diverticulectomy (n = 9) or appendectomy alone (n = 13). We compared clinical outcomes in both groups over a median follow-up period of 46 mo. RESULTS: All patients were successfully treated with initial therapy. Of the 102 patients who initially received only antibiotic treatment, 6 (6%) had a recurrence (3 in the cecum and 3 in the ascending colon or transverse colon) during the follow-up period. Five of these patients were managed with repeated antibiotic treatment and 1 underwent ileocolic resection for perforation. Of the 30 patients treated by the laparoscopic approach, 2 (7%) had a recurrence (ascending colon) which was treated with antibiotics. CONCLUSION: Initial antibiotic management for suspected uncomplicated cecal diverticulitis showed comparable efficacy to laparoscopic treatment in the prevention of recurrence.
Authors: B Papaziogas; J Makris; I Koutelidakis; G Paraskevas; B Oikonomou; E Papadopoulos; K Atmatzidis Journal: Int J Colorectal Dis Date: 2004-09-04 Impact factor: 2.571
Authors: Jae Hak Kim; Jae Hee Cheon; Sooyoung Park; Byung Chang Kim; Sang Kil Lee; Tae Il Kim; Won Ho Kim Journal: Hepatogastroenterology Date: 2008 May-Jun
Authors: Süleyman Kalcan; Fatih Başak; Mustafa Hasbahçeci; Ali Kılıç; Tolga Canbak; İlyas Kudaş; Gürhan Baş; Orhan Alimoğlu Journal: Ulus Cerrahi Derg Date: 2015-06-24
Authors: Dimitrios S Kyziridis; Styliani N Parpoudi; Nikolaos D Antoniou; Dimitrios Ch Konstantaras; Moysis G Moysidis; Emmanuel Ch Christoforidis; Konstantinos G Tsalis Journal: Am J Case Rep Date: 2015-04-08