DIVERTICULAR-DISEASE OF THE COLON - OUR E XPERIENCE

The authors herein present their personal experience on the surgical t reatment of complicated diverticular disease. The series consists of 2 43 patients seen between January 1974 and May 1994, One hundred and fi fty nine (65.4%) were admitted in an elective and 84 (34.6%) in an eme rgency setting, Medical therapy was efficacious in resolving the clini cal symptoms in 133, One hundred and ten pts, were treated surgically: 91 (82.7%) underwent a left hemicolectomy (one-step surgery), 13 (11. 8%) the Hartmann's procedure and 6 (5.4%) a sigmoid resection. Between 1974 and 1980, when anastomoses were performed manually and an exclud ing colostomy was the procedure of choice, the reported rate of anasto motic dehiscence was 21%, With the technological break-through of mech anical staplers, that enabled the performance of colostomies ''on dema nd'' such rate decreased to 8% and finally to 2%, as reported during 1 987-94, The operative mortality, between 1974-84, of those patients wh o underwent emergency surgery was 14% and decreased to 3% between 1985 -94, The operative mortality of patients who underwent elective surger y between 1974-84 was 1.3% and decreased to 0% between 1985-1994, The authors underline the importance of respecting the surgical indication s and the proper evaluation of pre-operative parameters aiming at a on estep surgery, that reduces both post-operative complications and reco very time.