Journal Mobile Options
Table of Contents
Vol. 29, No. 4, 2012
Issue release date: November 2012
Dig Surg 2012;29:315–320
(DOI:10.1159/000342549)

Does Primary Anastomosis with Diversion Have Any Advantages over Hartmann’s Procedure in Acute Diverticulitis?

Masoomi H. · Stamos M.J. · Carmichael J.C. · Nguyen B. · Buchberg B. · Mills S.
Department of Surgery, Division of Colorectal Surgery, University of California, Irvine, Medical Center, Orange, Calif., USA

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background: The optimal treatment for acute complicated diverticulitis is still a matter of debate. We evaluated outcomes of primary anastomosis with proximal diversion (PAD) versus Hartman’s procedure (HP) in acute diverticulitis. Methods: Using the National Inpatient Sample database, we examined the clinical data of patients who underwent an urgent open colorectal resection (sigmoidectomy or anterior resection) for acute diverticulitis from 2002 to 2007 in the United States. We evaluated patient characteristics, patient comorbidities, perioperative complications, in-hospital mortality, length of hospital stay and total hospital charges between two groups. Results: A total of 99,259 patients underwent urgent surgery for acute diverticulitis during these years (Primary anastomosis without diversion: 39.3%; HP: 57.3% and PAD: 3.4%). The overall complication rate was lower in the PAD group compared with the HP group (PAD: 39.06% vs. HP: 40.84%; p = 0.04). Patients in the HP group had a shorter mean length of stay (12.5 vs.14.4 days, p < 0.001) and lower mean hospital costs (USD 65,037 vs. USD 73,440, p < 0.01) compared with the PAD group. Mortality was higher in the HP group (4.82 vs. 3.99%, p = 0.03). Conclusion: PAD has improved outcomes compared with HP, and should be considered in patients who are deemed candidates for two-stage operations for acute diverticulitis.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50