INTRODUCTION: Diverticular disease of the colon is a common condition in developed countries. For perforated diverticulitis Hartmann's procedure is a safe and quick treatment option. But intestinal restoration needs further interventions. This leads to high complication rates and cost. Therefore a critical evaluation of surgical treatment options is necessary. METHODS: During a period of 18 months 88 patients underwent surgical resection for diverticulitis. Forty patients had emergency surgery. Among those a primary anastomosis was performed in 21 patients. The other 19 patients had interval colostomy. Among 21 patients with primary anastomosis major complications occurred in two patients, vs. twelve in patients with Hartmann's operation (p = 0.03). In the Hartmann group eight patients had major general complications, vs. one patient in the group with primary anastomosis (p = 0.06). The mean hospital stay was 38 days after Hartmann's procedure, vs. 13 days for patients with primary anastomosis (p < 0.01). CONCLUSION: In emergency surgery for complicated diverticulitis primary anastomosis is not associated with an increased postoperative morbidity. A primary anastomosis reduces the need for further surgical interventions and complex re-operations. Thus, an overall reduction of morbidity, cost, complication rate and hospital stay is possible. Therefore this technique is advantageous for patients and hospitals.
INTRODUCTION:Diverticular disease of the colon is a common condition in developed countries. For perforated diverticulitis Hartmann's procedure is a safe and quick treatment option. But intestinal restoration needs further interventions. This leads to high complication rates and cost. Therefore a critical evaluation of surgical treatment options is necessary. METHODS: During a period of 18 months 88 patients underwent surgical resection for diverticulitis. Forty patients had emergency surgery. Among those a primary anastomosis was performed in 21 patients. The other 19 patients had interval colostomy. Among 21 patients with primary anastomosis major complications occurred in two patients, vs. twelve in patients with Hartmann's operation (p = 0.03). In the Hartmann group eight patients had major general complications, vs. one patient in the group with primary anastomosis (p = 0.06). The mean hospital stay was 38 days after Hartmann's procedure, vs. 13 days for patients with primary anastomosis (p < 0.01). CONCLUSION: In emergency surgery for complicated diverticulitis primary anastomosis is not associated with an increased postoperative morbidity. A primary anastomosis reduces the need for further surgical interventions and complex re-operations. Thus, an overall reduction of morbidity, cost, complication rate and hospital stay is possible. Therefore this technique is advantageous for patients and hospitals.
Authors: Tiffany K Weidner; John T Kidwell; David A Etzioni; Lindsey R Sangaralingham; Holly K Van Houten; Dennis Asante; Molly Moore Jeffery; Nilay Shah; Nabil Wasif Journal: J Gastrointest Surg Date: 2018-02-12 Impact factor: 3.452
Authors: Massimo Sartelli; Frederick A Moore; Luca Ansaloni; Salomone Di Saverio; Federico Coccolini; Ewen A Griffiths; Raul Coimbra; Ferdinando Agresta; Boris Sakakushev; Carlos A Ordoñez; Fikri M Abu-Zidan; Aleksandar Karamarkovic; Goran Augustin; David Costa Navarro; Jan Ulrych; Zaza Demetrashvili; Renato B Melo; Sanjay Marwah; Sanoop K Zachariah; Imtiaz Wani; Vishal G Shelat; Jae Il Kim; Michael McFarlane; Tadaja Pintar; Miran Rems; Miklosh Bala; Offir Ben-Ishay; Carlos Augusto Gomes; Mario Paulo Faro; Gerson Alves Pereira; Marco Catani; Gianluca Baiocchi; Roberto Bini; Gabriele Anania; Ionut Negoi; Zurabs Kecbaja; Abdelkarim H Omari; Yunfeng Cui; Jakub Kenig; Norio Sato; Andras Vereczkei; Matej Skrovina; Koray Das; Giovanni Bellanova; Isidoro Di Carlo; Helmut A Segovia Lohse; Victor Kong; Kenneth Y Kok; Damien Massalou; Dmitry Smirnov; Mahir Gachabayov; Georgios Gkiokas; Athanasios Marinis; Charalampos Spyropoulos; Ioannis Nikolopoulos; Konstantinos Bouliaris; Jaan Tepp; Varut Lohsiriwat; Elif Çolak; Arda Isik; Daniel Rios-Cruz; Rodolfo Soto; Ashraf Abbas; Cristian Tranà; Emanuele Caproli; Darija Soldatenkova; Francesco Corcione; Diego Piazza; Fausto Catena Journal: World J Emerg Surg Date: 2015-02-19 Impact factor: 5.469