[The changes in the emergency surgical treatment of diverticulitis in the last thirty-years].
BACKGROUND
The surgical management of diverticulitis in emergency is controversial: The primary reconstructive surgery or Hartmann's procedure?


METHODS
The Authors have analyzed our experience on 409 cases of diverticulitis from January 1975 to December 2004; 101/409 were treated in emergency and divided in two groups before and after December 1994. The patients were divided on Hinchey's classification, type of surgical procedure, ASA status and complications. The Authors have analyzed all cases by t-Student and chi2 analysis.


RESULTS
No difference between two groups on age, sex, concomitant diseases are observed. The hospital stay in patients treated in emergency was 10.2 days to 7.1 days in patients operated after 24 hours (p<0.05). The incidence of primary anastomosis in the second group is higher (p<0.03). The incidence of leaks in two groups was respectively 27.2% and 10.3% (p<0.005). The deaths were 12/101 (11.8%); 9 of these in III-IV stages of Hinchey's classification.


CONCLUSIONS
In the lasts ten years the surgical approach to diverticulitis in emergency is changed. The individual risks factors, the Hinchey's stage, play an important role in decision making. The Authors have registered a major indications to primary anastomosis in emergency.
Del Rio
Paolo
P
Clinica Chirurgica Generale e Trapianti d'Organo, Università degli Studi di Parma. paolo.del.rio@unipr.it
Dell'Abate
Paolo
P
Soliani
Paolo
P
Ziegler
Stefanie
S
Arcuri
Maria Francesca
MF
Sianesi
Mario
M
D003108:Colonic Diseases / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods; D004238:Diverticulitis / Q000601:surgery*; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors