Colonic diverticulitis in chemotherapy patients: Should operative indications change? A retrospective cohort study
| Autor: | Soumitra R. Eachempati, Garrett M. Nash, Fredric M. Pieracci, M. Cathy Pietanza, Philip S. Barie, Tushar Samdani, Alexander Weiss, Jaime Benarroch-Gampel |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer medicine.medical_treatment Antineoplastic Agents Article Diverticulitis Colonic Cohort Studies Immunocompromised Host Recurrence medicine Humans Elective surgery Aged Retrospective Studies Aged 80 and over Chemotherapy business.industry Cancer Postoperative complication Retrospective cohort study General Medicine Middle Aged Diverticulitis medicine.disease Colon cancer Surgery Elective Surgical Procedures Acute Disease Colonic Neoplasms Diverticular disease Female Morbidity Interval resection business Immunosuppression |
| Zdroj: | International Journal of Surgery. 12:1489-1494 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2014.10.032 |
| Popis: | Introduction: Management of the immunosuppressed patient with diverticular disease remains controversial. We report the largest series of colon cancer patients undergoing chemotherapy and hospitalized for acute diverticulitis, to determine whether recent treatment with systemic chemotherapy is associated with increased risk for/increased severity of recurrent diverticulitis. Methods: Retrospective cohort study of adult patients hospitalized for an initial episode of acute colonic diverticulitis at Memorial Sloan Kettering Cancer Center, 1988–2004. Outcomes in patients receiving systemic chemotherapy within one month of admission for diverticulitis (“Chemo”) were compared to outcomes of patients not receiving chemotherapy within the past month (“No-chemo”). Results: A total 131 patients met inclusion criteria. Chemo patients did not differ significantly from No-chemo group in terms of severity of acute diverticulitis at index admission (13.2% vs. 4.4%, respectively, p = 0.12), resumption of chemotherapy (median 2 months), failure of non-operative management (13.2% vs 4.4%, respectively, p = 0.12), frequency of recurrence (20.5% vs 18.5%), hospital length of stay (p = 0.08), and likelihood of interval resection (24.0% vs. 16.2%, respectively, p = 0.39). Chemo patients recurred with more severe disease, were more likely to undergo emergent surgery (75.0% vs. 23.5%, respectively, p = 0.03), and were more likely to be diverted (100.0% vs. 25.0%, respectively, p = 0.03). Chemo patients were significantly more likely to incur a postoperative complication (100% vs 9.1% p |
| Databáze: | OpenAIRE |
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