Operative Treatment of the Colonic Diverticular Disease

Choi, Moon Hwan; Hwang, Jae Kwan; Kim, Jong Heung

Abstract

PURPOSE
In recent years, colonic diverticular disease has increased rapidly because of high intraluminal pressure in the colon due to the low fiber westernized diet and the increasing number of elderly people. Furthermore, emergency operation is required in many cases. Therefore, the aim of this study is proposed to review the optimal treatment guide. METHODS: This study is a retrospective review of the hospital records of 34 patients who underwent surgical treatment for colonic diverticular diseases at the National Medical Center from March 1992 to July 2003. RESULTS: The patients consisted of 23 males and 11 females, with mean age of 49 years. The lesion sites were cecum (62%), sigmoid colon (20%), ascending colon (9%), transverse colon (6%) and descending colon (3%), in descending orders of frequency. The patients were staged by Thorsen classification at the right colon and by Hinchey classification at the other sites. At the right colon, there were no cases of stage IV and 2 of bleeding. At the transverse colon and left colon, there were 3 cases of stage II, 5 of III, and 2 of IV. For the right colon, all patients underwent one- stage operation. For the other sites, 3 one- stage operations and 7 two- stage operations were performed. Major or minor postoperative complications occurred in 12 patients, including 2 mortality cases. Among them, 2 cases with colocutaneous fistulas might have been prevented if the operation had been made on the basis of stage. CONCLUSION: Because diverticular disease occurs at the various sites of the colon and has potential risk, it is important that patient treatment is based on stage.