Management of uncomplicated diverticular disease by colonic resection in patients at St. Mark's Hospital, 1964-9

Penfold, J. C. B.

doi:10.1002/bjs.1800600909

Cited by 12 publications

(8 citation statements)

References 19 publications

(7 reference statements)

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“…Ten patients (40 per cent) in the present series who were operated on for uncomplicated diverticular disease had persisting symptoms at follow-up-a result very similar to that obtained with resection at St Mark's Hospital (Penfold, 1973). Barium enema examination in 18 of these 25 patients showed no change in 7 (28 per cent) and deterioration in 6 (24 per cent).…”

Section: Acknowledgementssupporting

confidence: 78%

“…Reilly (1969) has advocated the operation particularly for uncomplicated cases of diverticular disease, but also has obtained satisfactory results in patients with complicated diverticular disease as long as surgery is not carried out in the presence of pus or peritonitis. The place of the operation is difficult to define in view of the good results of the alternative traditional procedure of colonic resection for diverticular disease (Todd, 1955;Thompson, 1959; Wilson, 1970;Penfold, 1973), and there is a need for an independent appraisal of the operative difficulties and complications and of the long term follow-up. …”

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confidence: 99%

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Distal colomyotomy: Follow-up of 37 cases

McGinn

1976

British Journal of Surgery

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The 3-7-year follow-up results of 37 patients undergoing the operation of distal colomyotomy are reported. Twenty-five underwent surgery for uncomplicated diverticular disease; there was no mortality but 40 per cent of patients had recurrent symptoms. Twelve patients underwent surgery for complicated diverticular disease, with an operative mortality of 16-6 per cent and a recurrent symptom rate of 37-5 per cent.

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Section: Acknowledgementssupporting

confidence: 78%

mentioning

confidence: 99%

Distal colomyotomy: Follow-up of 37 cases

McGinn

1976

British Journal of Surgery

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“…According to a review of the literature, the severe complication of leaking of the anastomosis occurs in 0-7% of patients [19]. The mortality of elective resection for acute diverticulitis in large series lies between 0% and 2% [12,19,20,29,[53][54][55][56][57][58][59][60][61].…”

Section: Individual Risk Factors For a Complicated Course Of Diverticmentioning

confidence: 99%

Evidence-based surgery: diverticulitis - a surgical disease?

Farthmann

Rückauer

Häring

2000

Langenbeck's Archives of Surgery

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Sigmoid diverticulitis is an increasingly common disorder. While there is no gender difference, the incidence increases with age. Many reports have been published on the topic, but there is no consensus on certain aspects of treatment. We conducted a literature search covering the past 30 years and report our own data. Two major areas of controversy exist. One concerns indications for elective surgery for symptomatic diverticulitis. The consensus is that there is no indication for prophylactic surgery. The first attack should be treated conservatively; elective surgery is considered following a second attack, but in immunocompromised patients earlier. The second controversy concerns surgical strategy in peritonitis from perforation. Three-stage operations have generally been abandoned. The question is whether to perform a sigmoid resection with primary anastomosis. One end of the spectrum is recent perforation which can be treated safely by resection and anastomosis. The other end is advanced feculent peritonitis in high-risk patients. In this situation a Hartmann procedure is recommended. Although data from prospective randomized studies are lacking, there seem to be indicators in the individual situation that allow a rational selection of the appropriate procedure. Diverticulitis can thus be treated surgically for a broad range of its forms of presentation.

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“…Until recently a two-staged procedure, usually as described by Hartmann [11, 12], has been the most common method for treating patients who require emergency surgery for complicated diverticular disease of the sigmoid colon [5,6,7,8,9,10,13,14,15,16], but it is also used when technical difficulties are encountered in electively operated patients [17, 18]. …”

Section: Introductionmentioning

confidence: 99%

Reversal of Hartmann’s Procedure after Surgery for Complications of Diverticular Disease of the Sigmoid Colon Is Safe and Possible in Most Patients

2005

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Background: Although evidence is growing that most patients who need an operation for diverticular disease of the sigmoid colon can be treated by a single-stage procedure, a two-stage procedure will still be necessary in some patients because of significant sepsis or technical difficulties. The outcomes of 65 patients who underwent secondary restoration after a Hartmann procedure for complicated diverticulitis were studied and the factors leading to complications and mortality were identified. Patients and Methods: Of 91 patients, in a consecutive 12-year period, whose primary operation was a Hartmann procedure, 72 survived longer than 3 months after discharge. Sixty-five underwent an attempted reversal of the Hartmann procedure. The POSSUM scores were calculated in all patients as well as the morbidity and mortality rates. Results: In 63 (96.9%) patients the bowel continuity could be restored with a morbidity of 38.5% and a mortality of 3.1%. The POSSUM and p-POSSUM scores adequately predicted the mortality in this series. Conclusion: This series shows that when surgical treatment for complicated diverticular disease of the sigmoid colon is necessary, the Hartmann procedure is still a valid indication. In a high percentage of patients the Hartmann procedure could be restored with a low mortality.

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Management of uncomplicated diverticular disease by colonic resection in patients at St. Mark's Hospital, 1964-9

Cited by 12 publications

References 19 publications

Distal colomyotomy: Follow-up of 37 cases

Distal colomyotomy: Follow-up of 37 cases

Evidence-based surgery: diverticulitis - a surgical disease?

Reversal of Hartmann’s Procedure after Surgery for Complications of Diverticular Disease of the Sigmoid Colon Is Safe and Possible in Most Patients

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