DEVELOPMENTS IN THE SURGICAL-TREATMENT IN COLONIC DIVERTICULITIS

All patients admitted to our department with diverticulitis of the lef t sided colon between 1980 and 1990 were retrospectively evaluated. St aging was performed according to the Hinchey classification. Altogethe r, 263 patients were evaluated; 71% had complicated diverticulitis and 29% simple diverticulitis. Of those patients with complicated diverti culitis, 68% required surgery due to abscess formation and/or perforat ion, 19% because of obstruction, 10% because of fistula formation, and 3% due to intestinal hemorrhage. While primary resection (primary rea nastomosis in 82% or Hartmann procedure in 13%) was carried out in 250 patients (95%), 13 patients (5%) did not obtain this result (colostom y) following the initial operation. None of the patients who presented with simple diverticulitis died in the postoperative period. The tota l operative mortality and mortality for complicated diverticulitis amo unted to 6.5% and 9%, respectively. In comparison to a former analysis from our department, resection of the primary focus during the initia l operation led to a significant decrease in morbidity and mortality. In patients with complicated diverticulitis and peritonitis, primary r esection and anastomosis also achieved favourable results in 78%.