title: [Surgical treatment for colonic diverticular disease. Experience in the INCMNSZ].
abstract: BACKGROUND
  Even though most patients with colonic diverticular disease respond to conservative management, some patients persist with symptoms or develop complications that require surgery. The objective of this study was to identify main surgical indications for colonic diverticular disease, and to evaluate the outcomes of surgical treatment.
  
  
  METHODS
  A retrospective review of patients that underwent a surgical procedure for colonic diverticular disease from 1979 through 2000, was performed. Surgical indications were acute diverticulitis (54%) (group 1), stenosis (19%), fistula (9.54), recurrent diverticulitis (9.5%) and bleeding (8%) (group 2). Results. Seventy-four patients with a mean age of 56 years were studied. Fifty-eight percent were male. Surgical morbidity and mortality rates of acute diverticulitis were 55%, and 15%, respectively. The surgical procedures of this group were proximal stomas (45%), Hartmann's procedures (38%), and resections with primary anastomosis (17%). Second group morbidity and mortality rates were 35 and 5.8%, respectively. Thirty-six patients underwent two or more surgical procedures with statistical significance between first and second groups (61 vs. 28%; p < 0.05). The mortality of two-stage surgeries was lower than derivative procedures (13 vs. 22%; p = 0.009). A high Hinchey's score was the only factor associated with mortality (28.5 vs. 0%; p = 0.042).
  
  
  CONCLUSIONS
  Mortality of surgical procedures for colonic diverticular disease is associated with a high Hinchey score. Primary anastomosis is o safe, procedure in some cases.
authors.affiliation: Dirección de Cirugía, Servicio de Cirugía Colorrectal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
authors.forename: Omar
authors.initials: O
authors.lastname: Vergara-Fernández
authors.forename: Liliana
authors.initials: L
authors.lastname: Velasco
authors.forename: Xeily
authors.initials: X
authors.lastname: Zárate
authors.forename: José Martín
authors.initials: JM
authors.lastname: Morales-Olivera
authors.forename: José María
authors.initials: JM
authors.lastname: Remes
authors.forename: Quintín H
authors.initials: QH
authors.lastname: González
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takahashi-Monroy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D003125:Colostomy / Q000379:methods; D043963:Diverticulosis, Colonic / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies