| 摘要 |
We desire twenty-six cases of right-sided diverticulitis at our hospital during a 5-year period and discuss the most appropriate atrategy for this condition. There were 14 men and 12 women with ages ranging from 17 to 86 years (mean 41.2). A preoperative diagnosis of appendicitis was made in 23(88%) of these patients. Four patients(15%) presented with fever, 18(69%)had symptoms for longer than 24hrs, and 21(81%) had an elevated white blood cell count. Twenty-four of the patients underwent surgery, without bowel preparation. During surgery, cecal diverticulitis was found in 13 patients and ascending colon diverticulitis was found in 11 patients. One patient received a segmental resection, three patients had a diverticulectomy with appendectomy, and twenty patients received an appendectomy with drainage and postoperative antibiotic therapy. The mean hospital stay was 9.5 days(ranged form 7 to 29). There were 2 postoperative wound infections and no operative mortality. The mean follow up period was 1.7 years(ranged from 2 months to 4.5 years). There were no recurrences during this period.
Our experience shows that conservative antibiotic treatment was first considered if the diagnosis was made preoperatively. Appendectomy with drainage and postoperative antibiotic therapy may be suitable for most uncomplicated cases diagnosed during surgery. Diverticulectomy is feasible for polypoid diverticula with a narrow base. Right hemicolectomy is performed when malignancy is considered, of if there is perforation of abscess formation. |
