Percutaneous drainage of colonic diverticular abscess: is colon resection necessary?
Dis Colon Rectum
; 56(5): 622-6, 2013 May.
Article
em En
| MEDLINE
| ID: mdl-23575402
ABSTRACT
BACKGROUND:
Recurrent diverticulitis has been reported in up to 30% to 40% of patients who recover from an episode of colonic diverticular abscess, so elective interval resection is traditionally recommended.OBJECTIVE:
The aim of this study was to review the outcomes of patients who underwent percutaneous drainage of colonic diverticular abscess without subsequent operative intervention.DESIGN:
This was an observational study. SETTINGS This investigation was conducted at a tertiary care academic medical center and a single-hospital health system. PATIENTS Patients treated for symptomatic colonic diverticular abscess from 2002 through 2007 were included. MAIN OUTCOMEMEASURES:
The primary outcomes measured were complications, recurrence, and colectomy-free survival.RESULTS:
Two hundred eighteen patients underwent percutaneous drainage of colonic diverticular abscesses. Thirty-two patients (15%) did not undergo subsequent colonic resection. Abscess location was pelvic (n = 9) and paracolic (n = 23), the mean abscess size was 4.2 cm, and the median duration of percutaneous drainage was 20 days. The comorbidities of this group of patients included severe cardiac disease (n = 16), immunodeficiency (n = 7), and severe pulmonary disease (n = 6). Freedom from recurrence at 7.4 years was 0.58 (95% CI 0.42-0.73). All recurrences were managed nonoperatively. Recurrence was significantly associated with an abscess size larger than 5 cm. Colectomy-free survival at 7.4 years was 0.17 (95% CI 0.13-0.21).LIMITATIONS:
This study was limited by its retrospective, nonexperimental design and short follow-up.CONCLUSION:
In selected patients, observation after percutaneous drainage of colonic diverticular abscess appears to be a safe and low-risk management option.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Drenagem
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Colectomia
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Abscesso Abdominal
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Abscesso
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Doença Diverticular do Colo
Tipo de estudo:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article