[Resection with primary anastomosis in complicated diverticulitis. Risk analysis].
107 patients operated for complicated diverticulitis 1988 until 1993 were analysed retrospectively regarding perioperative risk of resection with primary anastomosis (n = 94). 53 of them had peridiverticulitis with stenosis (mortality 0), 41 had emergency operations (mortality 14.6%). Hartmann procedure (n = 13, mortality 7.6%) has been accepted only for the following situations: 1. ileus with secondary damage of the bowel, 2. extended diffuse peritonitis with secondary organ failure, 3. poor blood supply of the bowel, 4. the patient under immunosuppression after transplantation. Regarding these recommendations mortality rate in emergency operations (12.9%) has been lower as compared to 15 to 20% in literature. So regarding the recommendations named above resection with primary anastomosis seems to be a safe procedure in complicated diverticulitis.
Schulz
C
C
Chirurgische Klinik und Poliklinik, Universitätsklinikum Rudolf Virchow Berlin.
Lemmens
H P
HP
Weidemann
H
H
Rivas
E
E
Neuhaus
P
P
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D003108:Colonic Diseases / Q000401:mortality / Q000601:surgery*; D004239:Diverticulitis, Colonic / Q000401:mortality / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000401:mortality / Q000601:surgery*; D007416:Intestinal Perforation / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D015996:Survival Rate
Die Resektion mit primärer Anastomose bei der komplizierten Diverticulitis. Eine Risikoanalyse.