背景:急性右侧结肠憩室炎(RCD)是亚洲人群的常见疾病,其最佳治疗方法仍存在争议。这项研究的目的是研究急性RCD患者的治疗方法并评估其长期预后。
方法:我们回顾性收集并分析了同仁医院收治的急性RCD患者的临床资料。上海交通大学医学院2015年12月至2020年12月。将患者分为两组,根据主要治疗策略,无论是保守治疗还是手术治疗。
结果:共纳入162例急性RCD患者。在年龄上没有显著差异,性别,腹部手术史,医学合并症,发烧,刚果民盟以前的历史,保守组和手术组的治疗成功率和并发症发生率。然而,保守组的复发率明显高于手术组(16.53%vs2.44%,P=0.020)。更频繁的排便和以前的RCD病史增加了急性RCD复发的风险。此外,无并发症憩室炎患者和复杂憩室炎患者在治疗成功率和总复发率方面均无显著差异.
结论:手术治疗急性RCD也是安全有效的。对于有复发危险因素(排便较频繁且既往有RCD病史)或并发急性RCD的急性RCD患者,应主要考虑手术治疗。
BACKGROUND: Acute right-sided colonic diverticulitis (RCD) is a common disease in Asian populations for which the optimal treatment remains controversial. The aim of this study was to investigate management and evaluate long-term outcomes of treatment in patients with acute RCD.
METHODS: We retrospectively collected and analyzed clinical data for patients with acute RCD admitted to the Tongren Hospital, Shanghai Jiao Tong University School of Medicine from December 2015 to December 2020. The patients were divided into two groups, according to primary treatment strategy, which was either conservative treatment or surgical treatment.
RESULTS: A total of 162 consecutive patients with acute RCD were enrolled in the study. There was no significant difference in age, sex, history of abdominal surgery, medical co-morbidities, fever, previous history of RCD, treatment success rate and incidence of complications between the conservative and surgery groups. However, the recurrence rate in conservative groups was significantly higher than in surgery groups (16.53% vs 2.44%, P = 0.020). And more frequent bowel movements and previous history of RCD increased the risk of recurrence of acute RCD. Moreover, there was no significant difference in either treatment success rate or the overall recurrence rate between the patients with uncomplicated diverticulitis and patients with complicated diverticulitis.
CONCLUSIONS: Surgical treatment is also safe and effective for acute RCD. Surgical treatment should mainly be considered for patients with acute RCD with recurrence risk factors (more frequent bowel movements and previous history of RCD) or with complicated acute RCD.