title: Emergency surgery in colonic diverticulitis in an Asian population.
abstract: BACKGROUND
  Diverticulitis in Asians differs significantly from their Western counterparts in various aspects. This study was performed to highlight our institution's surgical experiences in patients with diverticulitis. The secondary aim was to compare the patients who underwent surgery for right- and left-sided diverticulitis.
  
  
  METHODS
  A retrospective review of all patients who underwent emergency surgery in patients with acute diverticulitis from July 2003 to April 2008 was performed. Right-sided pathology was regarded if it was located from the caecum till the transverse colon. Left-sided disease was regarded if it commenced from the splenic flexure.
  
  
  RESULTS
  The study group comprised of 104 patients, 68 (65.4%) of whom had right-sided diverticulitis. Caecum was the commonest site of disease, and the majority had only mild disease. In the 36 (34.6%) patients with left-sided diverticulitis, majority (63.8%) had an ASA score of three or four, with the sigmoid colon being the most common site of involvement. Most (91.7%) had worse peritoneal contamination with Hartmann's procedure being performed in 22 (61.1%) patients. Worse peri-operative outcome was also seen in this group. After multivariate analysis, the independent factors for right-sided disease were younger age, lower ASA score and no necessity for stoma.
  
  
  CONCLUSIONS
  In an Asian population, surgery in right-sided diverticulitis is more commonly performed and is associated with lower morbidity and mortality. Patients who underwent surgery for right-sided diverticulitis were younger, with lower ASA score and less likely to have stoma created.
authors.affiliation: Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. kerkan@gmail.com
authors.forename: Ker-Kan
authors.initials: KK
authors.lastname: Tan
authors.forename: Jody Zhiyang
authors.initials: JZ
authors.lastname: Liu
authors.forename: Sharon Fengli
authors.initials: SF
authors.lastname: Shen
authors.forename: Richard
authors.initials: R
authors.lastname: Sim
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D004239:Diverticulitis, Colonic / Q000601:surgery*; D004638:Emergency Treatment / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000209:etiology; D012720:Severity of Illness Index; D055815:Young Adult