FAUT-IL ETRE AGRESSIF DANS LE TRAITEMENT CHIRURGICAL DE LA DIVERTICULITE COLIQUE?

A series of 61 consecutive cases with diverticular disease and its complications is presented. 14 cases with uncomplicated diverticular disease and 3 with massive GI tract hemorrhage underwent an uneventful (segmental) resection. Of 6 cases operated for fistula formation 1 died. Surgical therapy for abscess formation, peritonitis and 'pseudo-tumoral' obstruction (38 cases) carried a high mortality (26.3%). The application of a one-stage aggressive and curative surgical approach lowers the mortality considerably, especially in the complicated forms of the disease. In a group of 30 cases so treated only 1 death occurred (3.3%). This in contrast with a group of 31 patients treated with a two-stage and initially palliative procedure with a mortality of 10 (32.2%). The Hartman procedure with total excision of the lesion and avoidance of an enteroenteric anastomosis gives excellent results in the treatment of the complicated forms of the disease.SCOPUS: NotDefined.j