Sigmoid diverticulitis. Longitudinal analysis of 222 patients with a minimal follow up of 5 years.
OBJECTIVE
The surgical treatment of severe attacks of sigmoid diverticulitis and the indications for prophylactic surgery are currently matters of debate. We have analysed our experience in a university hospital, bringing new information into the discussion.


METHODS
All patients admitted to our department between 1995 and 2002 for an attack of sigmoid diverticulitis were reviewed. There were 222 who had had a first attack and these formed the basis of the study. Analysis of short- and long-term outcomes was made.


RESULTS
Of the 222 patients, 66 underwent an operation during the first admission (mainly Hartmann's operation) with no death. Twenty-five patients were operated during a subsequent admission, either for a deterioration of their symptoms or prophylaxis. One hundred and twenty-eight patients were managed conservatively, and were followed up for 5-12 years. Recurrence was observed in 43% of the patients with a trend to a higher incidence in patients under 50 years. Recurrent exacerbating diverticulitis were severe in 13% of cases.


CONCLUSIONS
Complicated diverticulitis can be managed with a low mortality. Hartmann's operation was proven safe in our experience. The risk of recurrence was higher than observed in many recent studies but few recurrences were severe.
Frileux
P
P
Department of Digestive Surgery, Hôpital Foch, Université Versailles Saint-Quentin, Suresnes Cedex, France. p.frileux@hopital-foch.org
Dubrez
J
J
Burdy
G
G
Roullet-Audy
J-C
JC
Dalban-Sillas
B
B
Bonnaventure
F
F
Frileux
M-A
MA
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003082:Colectomy; D004238:Diverticulitis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
D000900:Anti-Bacterial Agents