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Acute diverticulitis in younger patients:Any rationale for a different approach?

Acute diverticulitis in younger patients:Any rationale for a different approach?
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摘要 AIM:To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently. METHODS:This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1,2004 and December 31,2007.Diverticulitis was stratified according to the Hinchey classification. Patients were divided into 2 populations:group A≤ 50 years(n=31) ;group B>50 years(n=126) .Mean patient follow-up was 15 mo. RESULTS:The median age was 60 years.A significantly higher proportion of patients in group B presented with complicated diverticulitis(36.5%vs 12.9%,P=0.01) .Recurrence was more frequent in group A(25.8%vs 11.1%,P=0.03) and the mean time-torecurrence was shorter(12 mo vs 28 mo,P=0.26) . The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stageⅠand none of the patients required emergency surgery.In multivariate analysis,only age(P=0.024) was identified as an independent prognostic factor for recurrence. CONCLUSION:Based on the results of this study,we recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient. AIM:To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently. METHODS:This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1,2004 and December 31,2007.Diverticulitis was stratified according to the Hinchey classification. Patients were divided into 2 populations:group A≤ 50 years(n=31) ;group B50 years(n=126) .Mean patient follow-up was 15 mo. RESULTS:The median age was 60 years.A significantly higher proportion of patients in group B presented with complicated diverticulitis(36.5%vs 12.9%,P=0.01) .Recurrence was more frequent in group A(25.8%vs 11.1%,P=0.03) and the mean time-torecurrence was shorter(12 mo vs 28 mo,P=0.26) . The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stageⅠand none of the patients required emergency surgery.In multivariate analysis,only age(P=0.024) was identified as an independent prognostic factor for recurrence. CONCLUSION:Based on the results of this study,we recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.
出处 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第2期207-212,共6页 世界胃肠病学杂志(英文版)
关键词 Acute diverticulitis RECURRENCE Age factors SEVERITY Surgical treatment 患者 急性 原理 平均年龄 平均时间 多变量分析 年龄组 严重程度
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