Prospective Multicentre Evaluation of Adverse Outcomes Following Treatment for Complicated Diverticular Disease.
From: Imperial College London, Department of Surgical Oncology and Technology, St Mary’s Hospital, London, UK.
The British journal of surgery
- Publish Date: Dec 2006
- ISSN: 0007-1323
- Volume: 93
- Issue: 12
- Pages: 1503-13
- Medium: Print
- Language: English
- Citation (JAMA): Constantinides V A, Tekkis P P, Senapati A, et al. Prospective Multicentre Evaluation of Adverse Outcomes Following Treatment for Complicated Diverticular Disease.. Dec 2006;93:1503-13
Abstract
BACKGROUND: The choice of operation for complicated diverticular disease is contentious. The aim of this study was to investigate adverse events following restorative (primary resection and anastomosis, PRA) and non-restorative (Hartmann’s procedure, HP) surgery for complicated diverticular disease. METHODS: Five hundred and thirty-nine patients who presented with complicated diverticular disease in 42 centres over a 12-month period from January 2003 were considered for the study. Data were collected prospectively from 248 patients (46.0 per cent) who underwent PRA and 167 (31.0 per cent) who had HP. A propensity score was developed for case-mix adjustment. Multifactorial logistic regression was used to evaluate differences in operative outcomes. RESULTS: Mortality, surgical and medical complication rates were 4.0, 31.0 and 13.7 per cent respectively after PRA, and 23.4, 53.3 and 40.7 per cent for HP (all P < 0.001). After adjusting for the propensity score, the HP group had a 2.1- and 1.9-fold increase in medical and surgical complications respectively compared with those who had PRA, whereas the operative mortality rate was not significantly different. Non-colorectal surgeons performed a significantly higher proportion of HPs in the non-elective setting than colorectal surgeons (80.6 versus 60.4 per cent; chi(2) = 8.31, 1 d.f., P = 0.004). CONCLUSION: PRA with or without a proximal diversion is more often performed non-electively by specialist colorectal surgeons. It may be a safe procedure for complicated diverticular disease in selected patients as it may be associated with fewer postoperative adverse events.
Mesh Headings (Keywords): Adult, Aged, Aged, 80 and over, Anastomosis, Surgical, Digestive System Surgical Procedures, Diverticulum, Colon, Female, Humans, Male, Middle Aged, Multivariate Analysis, Postoperative Complications, Prospective Studies, Risk Factors, Treatment Outcome
Check for Full Text / PubMed Unique Identifier (PMID): 17048279
This abstract is part of PubMed, a service of the U.S. National Library of Medicine. PubMed includes more than 17 million citations from MEDLINE and other life science journals for biomedical articles. See Copyright and Disclaimers.
Linked medical terms appearing on this page are added by Healia to help readers find more information and are not part of the original PubMed document.
The data herein was last updated on July 8th, 2008 and may not reflect the most current and accurate data available from NLM.