[Does one have to be aggressive in the surgical management of diverticular disease of the colon (author's transl)].
A series of 61 consecutive cases with diverticular disease and its complications is presented. Fourteen cases with uncomplicated diverticular disease and 3 with massive GI tract hemorrhage underwent an uneventful (segmental) resection. Of 6 cases operated for fistula formation 1 died. Surgical therapy for abscessformation, peritonitis and "pseudo-tumoral" obstruction (38 cases) carried a high mortality (26.3%). The application of a one-staged aggressive and curative surgical approach lowers the mortality considerably, especially in the complicated forms of the disease. In a group of 30 cases so treated only 1 death occurred (3.3%). This in contrast with a group of 31 patients treated with a two-staged and initially palliative procedure with a mortality of 10 (32.2%). The Hartmann procedure with total excision of the lesion and avoidance of an enteroenteric anastomosis gives excellent results in the treatment of the complicated forms of the disease.
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000209:etiology; D004239:Diverticulitis, Colonic / Q000150:complications / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D008722:Methods; D008875:Middle Aged; D010166:Palliative Care; D010347:Patient Care Planning; D010538:Peritonitis / Q000209:etiology
Faut-il être agressif dans le traitement chirurgical de la diverticulite colique?