대장 게실염의 수술적 치료에 대한 분석

김광연; 김일건; 정성원; 박건환; 박영진

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자료유형: 학술저널

저자정보: 김광연 (인제대학교) 김일건 (인제대학교) 정성원 (인제대학교) 박건환 (인제대학교) 박영진 (동국대학교)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research 대한외과학회지 Vol.73 No.1

발행연도: 2007.7

수록면: 36 - 41 (6page)

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Purpose: With the gradual changes in the diet, the incidence of colonic diverticular disease, particularly that of the left side colon, has increased rapidly in Korea. The aim of this study was to evaluate the clinical features of diverticular disease and to compare the differences in treatment between right and left colonic diverticulitis.
Methods: The hospital records of 67 patients with diverticulitis were reviewed retrospectively.
Results: The incidence of right side colonic diverticulitis was 2.5 times higher than that of the left side (48 and 19 cases, respectively). The mean age of the patients was 51.3 years with a male to female ratio of 2.1：1. The left side colonic diverticulitis developed at an older age than that of the right side (mean age of 47.2 and 58.7 years, respectively, P=0.03). Seventeen out of 48 (35.4%) right and 8 out of 19 (42.1%) left colonic diverticulitis patients were treated surgically. The ratio of surgical treatment was not different according to the location of diverticulitis (P=0.61). The age and gender of the patients or leucocytosis at the time of the diagnosis were not associated with the risk of surgical treatment. The presence of fever and high-grade sepsis on the CT scan(Hinchey grade) were significant risk factors for surgery. The symptom duration was longer in the surgically treated group than in the conservative treatment group in left colonic diverticulitis (P=0.03). Most surgical procedures for right colonic diverticulitis were a single-stage colon resection (16 out of 17 cases), whereas staged procedures including Hartmann"s operation (3 cases) and proximal diversion (2 cases) with abscess drainage were performed in 5 out of the 8 left colonic cases. Postoperative complications were more frequent in the left colon cases.
Conclusion: The left colon is a relatively rare site for diverticulitis in Korea. However, diverticulitis of this section of the colon requires more complicated surgical treatment and is associated with a higher rate of complications than that of the right colon. The earlier application of diagnostic work up might be necessary for patients suspected of having left colonic diverticulitis because a delayed diagnosis is associated with a risk of surgical treatment.

#Colon #Diverticulitis #대장 #게실염

참고문헌 (29)

참고문헌 신청

1. [단행본] - Corman ML / 2005 / Colon & Rectal Surgery. 5th ed / Lippincott Williams and Wilkins

2. [학술지(정기간행물)] - Rodkey GV / 1965 / Diverticulitis of the colon: evaluation in concept and therapy / Surg Clin North Am 45 : 1231 ~ 1243

3. [학술지(정기간행물)] - Sugihara K / 1984 / Diverticular disease of the colon: a review of 615 cases / Dis Colon Rectum 27 : 531 ~ 537

4. [학술지(정기간행물)] - Kim JS / 1993 / The prevalence and clinical features of diverticular disease of the colon / Korean J Gastroenterol 25 : 305 ~ 314

5. [학술지(정기간행물)] - Kim HU / 2003 / Clinical characteristics of colonic diverticulitis in Koreans / Korean J Gastroenterol 42 : 363 ~ 368

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