Enfermedad diverticular del colon, indicaciones y resultados del tratamiento quirúrgico electivo / Diverticular disease of the colon: indications and results of surgical treatment

ABSTRACT

Precise criteria were prospectively used to indicate surgery in patients with diverticular disease of the colon a) anatomical deformity of the sigmoid (ADS), including stenosis and fistulae with presence of contrast media extraluminally; b) recurrent acute diverticulitis (RAD); c) prior divericulitis with perforation (DP) and d) recurrent GI bleeding (GIB). 42 patients were operated on according to these criteria, from 1978 to 1988, 26 males and 16 females, with a mean age of 61 years (range to 93). ADS was the indication in 22 patients (52%), with fistulae presente in 9. RAD was the indication in 16 patients (37%), DP in 9 patients (21%) and GIB in 5%. All patients were submitted to either ample sigmoid ressuction or left hemicholectomy. All patients were followe, with a mean of 43 months for the series. Only 1 patient died after surgery from pulmonary embolism. Late clincial evaluation revealed abscense of preoperative symptoms and signs. We feel that surgical treatment of diverticular disese of the colon is warranted with the criteria described, with good immediate and longterm results: