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Erschienen in: Diseases of the Colon & Rectum 7/2008

01.07.2008 | Original Contribution

Persistent Symptoms After Elective Sigmoid Resection for Diverticulitis

verfasst von: Bernhard Egger, M.D., Matthias K. Peter, M.D., Daniel Candinas, M.D.

Erschienen in: Diseases of the Colon & Rectum | Ausgabe 7/2008

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Purpose

Despite technically successful surgery for diverticular disease, a significant group of patients who experience persistent or recurrent symptoms remains. This study was designed to determine the incidence and pattern of persistent symptoms and their association with peroperative parameters.

Methods

Follow-up (33 (range, 4–72) months) through structured interviews with patients who had surgery for diverticulitis in our department from December 1999 to November 2004 was conducted. Of 162 patients, 124 (76.5 percent) were available for follow-up. Nonparametric tests were used for comparison of patients who had undergone elective (n = 68) or emergency (n = 56) procedures.

Results

Of patients who had elective surgery, 25 percent suffered persistent symptoms, including painful constipation, painful abdominal distension, abdominal cramps, and frequent painful diarrhea. Neither the stage of disease (complicated or uncomplicated) nor the surgical technique (laparotomy or laparoscopy) were significantly related to the occurrence of symptoms. Recurrent diverticulitis was not observed. Similar results were obtained from comparisons with emergency patients.

Conclusions

The prevalence of persistent symptoms after successful surgery for diverticular disease may be an additional reason to carefully discuss the indication for prophylactic surgery. In any case, preoperative counseling and informed consent regarding the possibility of persistent symptoms after prophylactic elective surgery is essential.
Literatur
1.
Zurück zum Zitat Parks TG. Natural history of diverticular disease of the colon. Clin Gastroenterol 1975;4:53–69.PubMed Parks TG. Natural history of diverticular disease of the colon. Clin Gastroenterol 1975;4:53–69.PubMed
2.
Zurück zum Zitat Blake MF, Dwivedi A, Tootla A, Tootla F, Silva YJ. Laparoscopic sigmoid colectomy for chronic diverticular disease. JSLS 2005;9:382–5.PubMed Blake MF, Dwivedi A, Tootla A, Tootla F, Silva YJ. Laparoscopic sigmoid colectomy for chronic diverticular disease. JSLS 2005;9:382–5.PubMed
3.
Zurück zum Zitat Horgan AF, McConnell EJ, Wolff BG, The S, Paterson C. Atypical diverticular disease: surgical results. Dis Colon Rectum 2001;44:1315–8.PubMedCrossRef Horgan AF, McConnell EJ, Wolff BG, The S, Paterson C. Atypical diverticular disease: surgical results. Dis Colon Rectum 2001;44:1315–8.PubMedCrossRef
4.
Zurück zum Zitat Bassotti G, Battaglia E, de Roberto G, Morelli A, Tonini M, Villanacci V. Alterations in colonic motility and relationship to pain in colonic diverticulosis. Clin Gastroenterol Hepatol 2005;3:248–53.PubMedCrossRef Bassotti G, Battaglia E, de Roberto G, Morelli A, Tonini M, Villanacci V. Alterations in colonic motility and relationship to pain in colonic diverticulosis. Clin Gastroenterol Hepatol 2005;3:248–53.PubMedCrossRef
5.
Zurück zum Zitat Floch MH, Bina I. The natural history of diverticulitis: fact and theory. J Clin Gastroenterol 2004;38:S2–7.PubMedCrossRef Floch MH, Bina I. The natural history of diverticulitis: fact and theory. J Clin Gastroenterol 2004;38:S2–7.PubMedCrossRef
6.
Zurück zum Zitat Moreaux J, Vons C. Elective resection for diverticular disease of the sigmoid colon. Br J Surg 1990;77:1036–8.PubMedCrossRef Moreaux J, Vons C. Elective resection for diverticular disease of the sigmoid colon. Br J Surg 1990;77:1036–8.PubMedCrossRef
7.
Zurück zum Zitat Bacon HE, Berkley JL. The surgical management of diverticulitis of the colon with particular reference to rehabilitation. Arch Surg 1960;80:646–9.PubMed Bacon HE, Berkley JL. The surgical management of diverticulitis of the colon with particular reference to rehabilitation. Arch Surg 1960;80:646–9.PubMed
8.
Zurück zum Zitat Benn PL, Wolff BG, Ilstrup DM. Level of anastomosis and recurrent colonic diverticulitis. Am J Surg 1986;151:269–71.PubMedCrossRef Benn PL, Wolff BG, Ilstrup DM. Level of anastomosis and recurrent colonic diverticulitis. Am J Surg 1986;151:269–71.PubMedCrossRef
9.
Zurück zum Zitat Farmakis N, Tudor RG, Keighley MR. The 5-year natural history of complicated diverticular disease. Br J Surg 1994;81:733–5.PubMedCrossRef Farmakis N, Tudor RG, Keighley MR. The 5-year natural history of complicated diverticular disease. Br J Surg 1994;81:733–5.PubMedCrossRef
10.
Zurück zum Zitat Leigh JE, Judd ES, Waugh JM. Diverticulitis of the colon. Recurrence after apparently adequate segmental resection. Am J Surg 1962;103:51–4.PubMedCrossRef Leigh JE, Judd ES, Waugh JM. Diverticulitis of the colon. Recurrence after apparently adequate segmental resection. Am J Surg 1962;103:51–4.PubMedCrossRef
11.
Zurück zum Zitat Marsh J, Liem RK, Byrd BF Jr, Daniel RA. One hundred consecutive operations for diverticulitis of the colon. South Med J 1975;68:133–7.PubMed Marsh J, Liem RK, Byrd BF Jr, Daniel RA. One hundred consecutive operations for diverticulitis of the colon. South Med J 1975;68:133–7.PubMed
12.
Zurück zum Zitat Janes S, Meagher A, Frizelle FA. Elective surgery after acute diverticulitis. Br J Surg 2005;92:133–42.PubMedCrossRef Janes S, Meagher A, Frizelle FA. Elective surgery after acute diverticulitis. Br J Surg 2005;92:133–42.PubMedCrossRef
13.
Zurück zum Zitat Parks TG, Connell AM. The outcome in 455 patients admitted for treatment of diverticular disease of the colon. Br J Surg 1970;57:775–8.PubMedCrossRef Parks TG, Connell AM. The outcome in 455 patients admitted for treatment of diverticular disease of the colon. Br J Surg 1970;57:775–8.PubMedCrossRef
14.
Zurück zum Zitat Breen RE, Corman ML, Robertson WG, Prager ED. Are we really operating on diverticulitis? Dis Colon Rectum 1986;29:174–6.PubMedCrossRef Breen RE, Corman ML, Robertson WG, Prager ED. Are we really operating on diverticulitis? Dis Colon Rectum 1986;29:174–6.PubMedCrossRef
15.
Zurück zum Zitat Munson KD, Hensien MA, Jacob LN, Robinson AM, Liston WA. Diverticulitis: a comprehensive follow-up. Dis Colon Rectum 1996;39:318–22.PubMedCrossRef Munson KD, Hensien MA, Jacob LN, Robinson AM, Liston WA. Diverticulitis: a comprehensive follow-up. Dis Colon Rectum 1996;39:318–22.PubMedCrossRef
16.
Zurück zum Zitat Thorn M, Graf W, Stefansson T, Pahlman L. Clinical and functional results after elective colonic resection in 75 consecutive patients with diverticular disease. Am J Surg 2002;183:7–11.PubMedCrossRef Thorn M, Graf W, Stefansson T, Pahlman L. Clinical and functional results after elective colonic resection in 75 consecutive patients with diverticular disease. Am J Surg 2002;183:7–11.PubMedCrossRef
17.
Zurück zum Zitat Simpson J, Neal KR, Scholefield JH, Spiller RC. Patterns of pain in diverticular disease and the influence of acute diverticulitis. Eur J Gastroenterol Hepatol 2003;15:1005–10.PubMedCrossRef Simpson J, Neal KR, Scholefield JH, Spiller RC. Patterns of pain in diverticular disease and the influence of acute diverticulitis. Eur J Gastroenterol Hepatol 2003;15:1005–10.PubMedCrossRef
18.
Zurück zum Zitat Wong WD, Wexner SD, Lowry A, et al. Practice parameters for the treatment of sigmoid diverticulitis—supporting documentation. The Standards Task Force. The American Society of Colon and Rectal Surgeons. Dis Colon Rectum 2000;43:290–7.PubMedCrossRef Wong WD, Wexner SD, Lowry A, et al. Practice parameters for the treatment of sigmoid diverticulitis—supporting documentation. The Standards Task Force. The American Society of Colon and Rectal Surgeons. Dis Colon Rectum 2000;43:290–7.PubMedCrossRef
19.
Zurück zum Zitat Kohler L, Sauerland S, Neugebauer E. Diagnosis and treatment of diverticular disease: results of a consensus development conference. The Scientific Committee of the European Association for Endoscopic Surgery. Surg Endosc 1999;13:430–6.PubMedCrossRef Kohler L, Sauerland S, Neugebauer E. Diagnosis and treatment of diverticular disease: results of a consensus development conference. The Scientific Committee of the European Association for Endoscopic Surgery. Surg Endosc 1999;13:430–6.PubMedCrossRef
Metadaten
Titel
Persistent Symptoms After Elective Sigmoid Resection for Diverticulitis
verfasst von
Bernhard Egger, M.D.
Matthias K. Peter, M.D.
Daniel Candinas, M.D.
Publikationsdatum
01.07.2008
Verlag
Springer-Verlag
Erschienen in
Diseases of the Colon & Rectum / Ausgabe 7/2008
Print ISSN: 0012-3706
Elektronische ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-008-9234-3

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