La terapia chirurgica della malattia diverticolare in fase acuta. Nostra esperienza

Toccaceli, Stefano and Persico Stella, Luigi and Dandolo, Rossella and Diana, Massimo and Budak, A. and Di Pucchio, E. and Negro, Paolo (2009) La terapia chirurgica della malattia diverticolare in fase acuta. Nostra esperienza. Il giornale di chirurgia, 30 (5). pp. 219-225. ISSN 1971-145X

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The treatment of the acute diverticolitis is still a stimulating and complex problem sustained by several anatomopatological and clinical factors and the possibility of different therapeutic options, being the operative mortality among 5% and 45%. With the modern technologies it is possible to follow the evolution of the illness so to perform more appropriate therapeutic plan. From 1997 to 2007 we have observed 278 patients with acute diverticolitis. In 219 (78,7%) patients the inflammatory and sub-occlusive condition has been faced with medical therapy, with resolution of the disease in 170 (61%) cases. In 49 (17,6%) patients we have gotten the resolution of the inflammatory disease, but not of the sub-occlusion and therefore we liked to submit them to surgical treatment in election. In 1 case we have found a colovesical fistula. A total of 59 (21,2%) patients with signs of acute abdomen have been submitted to surgery in urgency, within the 24 hours from the hospitalization. We have performed a primary resection with anastomosis and without stomia in all the patients, except in 3 cases in which we have done the Hartmann procedure for the cheap general conditions. We have not recorded intra and postoperative mortality and only in 3 cases we have had a leakage, that has not needed a surgical treatment. In 9 cases we observed infection of the wound, treated with antibiotic therapy. In our experience, performing a surgical procedure, without derivative stomia and manual anastomosis, it seems to be the fittest and less expensive procedure, also in situation of emergency-urgency, without increase of mortality and morbility.

Item Type: Article
Uncontrolled Keywords: Diverticular disease, Diverticulitis, Surgery
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Nadia Del Gobbo
Date Deposited: 08 Feb 2016 14:16
Last Modified: 08 Feb 2016 14:16

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