Same Admission Colon Resection with Primary Anastomosis for Acute Diverticulitis
| Autor: | Melinda A. Maggard, Jesse E. Thompson, Paul J. Schmit, Charlie F. Chandler, Robert S. Bennion, Ahn Au, O. Joe Hines |
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| Rok vydání: | 1999 |
| Předmět: | |
| Zdroj: | The American Surgeon. 65:927-930 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313489906501006 |
| Popis: | Current standard of care for complicated diverticulitis includes urgent resection with colostomy versus antibiotic treatment, followed by delayed resection with primary anastomosis at a second admission. In certain circumstances, it is possible to perform resection and anastomosis on the same admission for acute diverticulitis. A retrospective review was completed for patients undergoing surgery for diverticulitis from 1991 to 1998. Groups included: 1) sigmoid resection with primary anastomosis on same admission (n = 18); 2) resection with protective end colostomy (n = 16); and 3) in-patient antibiotic treatment alone, followed by a second admission for resection with primary anastomosis (n = 5). Four patients initially treated with antibiotics worsened symptomatically or developed radiographic evidence of perforation and required resection with colostomy. Five patients in Group 1 had abscesses or contained perforations based on radiographic studies. Findings on CT scans did not predict treatment. Group 1 patients had uneventful recoveries and few minor complications (wound infections and an incisional hernia). One anastomotic leak occurred in Group 2 after colostomy closure. Although there will continue to be a role for emergent operation for diverticulitis, same admission sigmoid resection with primary anastomosis after antibiotic treatment is safe, uses a shorter course of antibiotics, and has a low complication rate. |
| Databáze: | OpenAIRE |
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