Emergency Operations for Colonic Diverticilitis: A Comparison between Right-sided and Left-sided Lesions

大腸憩室炎的緊急手術：右側大腸與左側大腸病灶的比較

蔡祥麟(Hsiang-Lin Tsai) ； 謝建勳(Jan-Sing Hsieh) ； 王照元(Jaw-Yuan Wang) ； 黃裕勝(Yu-Sheng Huang) ； 陳漢文(Hon-Man Chan) ； 侯明鋒(Ming-Feng Hou) ； 黃哲人(Che-Jen Huang) ； 黃宗人(Tsung-Jen Huang)

《中華民國大腸直腸外科醫學會雜誌》 15卷3期 (2004/09) Pp. 93-98

https://doi.org/10.6312/SCRSTW.2004.15(3).09317

摘要

Background. The incidence of diverticular disease of the colon is increasing as a consequence of rapid urban development and reduced dietary fiber intake. Surgical treatment for its complication is still associated with prominent morbidity. The aim of this study was to compare our results of emergency surgery for patients with right-sided and left-sided colonic diverticulitis in one single institution.
Materials. and Methods. Fifty-nine cases of colonic diverticular disease who underwent immediate operation within 24 hours of admission of the ER(emergency room) were collected from medical records during the eight-year period. Demographic data, type of operation, and surgical outcome of all patients were recorded(25 right-sided, 34 left-sided).
Results. Patients with right-sided lesions were significantly younger (mean age 48.5 ± 3.0 vs. 69.3 ± 2.2, p＜0.001), and there was a tendency to male predominance in right-sided colon disease and female predominance in left-sided.Postoperative mortality rates for right-sided disease and left-sided disease were 0% and 17.6% (p=0.027), respectively, and morbidity was 32% and 64.7% (p=0.013), respectively. Moreover, both longer hospital stay (p=0.012) and higher pre-morbid condition (p=0.002) were found in patients with left-sided diverticulitis.
Conclusions. There are major differences in the demographics and outcome of patients who had emergency surgery for colonic diverticulitis, with operation for left-sided diverticulitis being associated with significantly higher mortality and morbidity, as well as longer hospital stay.

關鍵字

緊急手術 ； 大腸憩室炎 ； 死亡率 ； 罹病率

並列摘要

Background. The incidence of diverticular disease of the colon is increasing as a consequence of rapid urban development and reduced dietary fiber intake. Surgical treatment for its complication is still associated with prominent morbidity. The aim of this study was to compare our results of emergency surgery for patients with right-sided and left-sided colonic diverticulitis in one single institution.
Materials. and Methods. Fifty-nine cases of colonic diverticular disease who underwent immediate operation within 24 hours of admission of the ER(emergency room) were collected from medical records during the eight-year period. Demographic data, type of operation, and surgical outcome of all patients were recorded(25 right-sided, 34 left-sided).
Results. Patients with right-sided lesions were significantly younger (mean age 48.5 ± 3.0 vs. 69.3 ± 2.2, p＜0.001), and there was a tendency to male predominance in right-sided colon disease and female predominance in left-sided.Postoperative mortality rates for right-sided disease and left-sided disease were 0% and 17.6% (p=0.027), respectively, and morbidity was 32% and 64.7% (p=0.013), respectively. Moreover, both longer hospital stay (p=0.012) and higher pre-morbid condition (p=0.002) were found in patients with left-sided diverticulitis.
Conclusions. There are major differences in the demographics and outcome of patients who had emergency surgery for colonic diverticulitis, with operation for left-sided diverticulitis being associated with significantly higher mortality and morbidity, as well as longer hospital stay.

並列關鍵字

Emergent surgery ； Diverticulitis ； Mortality ； Morbidity