Purpose: Colonic diverticular disease is a common disease worldwide. Complicated diverticulitis is determined by presence of perforation, abscess, phlegmon, stricture, obstruction, fistula or hemorrhage. It is an indication for operative management. The aim of the present study was to determine the indications for surgery of complicated diverticular disease, to compare resection with primary anastomosis to Hartmann`s procedure as the optimal urgent operative strategy for patients with complicated acute diverticulitis and to analyze the factors affecting the outcome.
Material and methods: Between 1999 and 2012, 250 patients with symptomatic colonic diverticular disease were hospitalized in the Department of General and Hepatopancreatic Surgery, University Hospital Alexandrovska of Sofia. Of them, 39 patients with complicated colonic diverticulitis were surgically treated. Several factors that could influence on the choice of surgical strategy were analyzed by means of SPSS 19.0.1 statistical package.
Results: Surgery was applied in 31 patients with perforation, one patient with diverticular bleeding, five patients with fistulas and two patients with bowel obstruction based on diverticular disease.
Conclusion: The surgical treatment of complicated diverticular disease, especially of that with peritonitis, remains a challenge. The performance of resection with primary anastomosis with or without protective stoma in selected patients is an alternative to Hartmann`s procedure.
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