The experience with 59 patients affected by diverticular disease who underwent surgery after failure of medical treatment, is reported. 40 patients showed one or more postoperative complications, 19 none. The operations performed were: in 46 cases one-stage resection with anastomosis, Hartmann's operation in 8 and other procedures in 5. Six patients died: 3 after Harmann's operation, 2 after colostomy and one after anastomosis. The mean stay in bed for complicated cases was 24 days after anastomosis and 36 after Hartmann's operation. Therefore anastomosis is preferred in all cases including those with stenosis, fistula or abscess provided that peritonitis is not present. The anastomosis is performed away from the site of abdominal sepsis. In cases with peritonitis the selected surgical procedure is usually Hartmann's operation.
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Cureus
December 2024
Department of Surgery, Kitakyushu City Yahata Hospital, Kitakyushu, JPN.
This report presents two cases of colonic perforation that occurred following an upper gastrointestinal series (UGIS) with barium as part of a health screening. UGIS is a widely performed examination in Japan and is useful for the early detection of gastric cancer and peptic ulcers, but it carries a rare risk of causing serious gastrointestinal perforation. This study details the mechanisms of perforation, risk factors, difficulties in imaging diagnosis, and treatment options.
View Article and Find Full Text PDFOphthalmology
December 2024
Department of Ophthalmology, Stanford University, Palo Alto, CA.
Objective: Achieving near normal vision following unilateral congenital cataract surgery is possible but requires early surgery, optical correction and consistent patching. Patching is often challenging for children and their caregivers. The goal of these analyses is to examine the association between reported consistency in patching during the first year after surgery and visual acuity.
View Article and Find Full Text PDFSurg Endosc
December 2024
Cancer Center Amsterdam, Amsterdam, Netherlands.
Background: The surgical management of complicated diverticulitis varies across Europe. EAES members prioritized this topic to be addressed by a clinical practice guideline through an online questionnaire.
Objective: To develop evidence-informed clinical practice recommendations for key stakeholders involved in the treatment of complicated diverticulitis; to improve operative and perioperative outcomes, patient experience and quality of life through a systematic evidence-to-decision approach by a diverse, multidisciplinary panel.
Surg Endosc
December 2024
Department of Surgery, Papageorgiou General Hospital, Thessaloniki, Greece.
Background: We performed a systematic review and network meta-analysis (NMA) of individualized patient data (IPD) to inform the development of evidence-informed clinical practice recommendations.
Methods: We searched MEDLINE, Embase, and Cochrane Central in October 2023 to identify RCTs comparing Hartmann's resection (HR), primary resection and anastomosis (PRA), or laparoscopic peritoneal lavage (LPL) among patients with class Ib-IV Hinchey diverticulitis. Outcomes of interest were prioritized by an international, multidisciplinary panel including two patient partners.
J Surg Case Rep
January 2025
DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL 33136, United States.
Colo-cutaneous fistulas are a rare complication of diverticular disease. Percutaneous drainage offers a promising alternative to surgical intervention in the management of complicated diverticular disease with abscess formation. Recent case studies and literature reviews support its efficacy in achieving abscess resolution and reducing the need for surgery.
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