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Primary resection and anastomosis for treatment of acute diverticulitis

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

The patterns of presentation and associated treatments of 65 patients with acute perforated diverticulitis of the left colon have been reviewed. Four types of operations were identified: primary resection with anastomosis (group I, N=29), primary resection with anastomosis and protective colostomy (group II, N=5), primary resection with Hartmann procedure (group III, N=26), and delayed resection three-staged procedure (group IV, N=5). The severity of disease was also classified (stages I to IV). Postoperative mortality rates in the first two groups were lower than that of the Hartmann group (3.4 vs. 15.3 percent). The mean length of initial hospitalization was 16±1.2 days for group I, 18.2±4.4 days for group II, 19.4±2 days for group III, 26.4±4.4 days for group IV (P<.05,t-test group IVvs. groups I, II, and III). Complications in the Hartmann group were high with a 23 percent wound infection rate and mortality after closure of colostomy and bowel reconstruction was 3.8 percent. These data demonstrate that primary resection with anastomosis is a satisfactory operation for the majority of patients with perforated diverticulitis (stages I to III), and there appears to be no clinical indication to use the three-staged operation.

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Authors and Affiliations

  1. Department of Surgery, St. Mary's Hospital, 56 Franklin Street, 06706, Waterbury, Connecticut

    Audencio Alanis M.D., George K. Papanicolaou M.D., Raafat R. Tadros M.D. &  L. Peter Fielding M.D.

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  1. Audencio Alanis M.D.
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  2. George K. Papanicolaou M.D.
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  3. Raafat R. Tadros M.D.
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  4. L. Peter Fielding M.D.
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Alanis, A., Papanicolaou, G.K., Tadros, R.R. et al. Primary resection and anastomosis for treatment of acute diverticulitis. Dis Colon Rectum 32, 933–939 (1989). https://doi.org/10.1007/BF02552268

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