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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.94 No.6
- 발행연도
- 2018.6
- 수록면
- 322 - 329 (8page)
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초록· 키워드
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Purpose: The incidence of colonic diverticular disease is increasing, and several grading systems based on CT findings have been developed. The objective of this study was to define the impact of various CT findings of colonic diverticulitis and to demonstrate which factors affect the need for operative treatment.
Methods: Three hundred fifty-seven patients diagnosed with colonic diverticulitis from January 2010 to July 2016 were retrospectively evaluated. Patients were excluded if pure diverticulosis, diverticular bleeding, colon cancer, or relevant data deficiencies, and the remaining patients (n = 178) were reviewed. Patients were categorized into a successful nonoperation group and an operation group. The operation group was then matched 1:2 with the nonoperative group based on age, gender, American Society of Anesthesiologists physical status classification, and body mass index.
Results: After propensity score matching, there were no significant differences regarding patients’ demographic characteristics between the 2 groups. Left location was more associated with need for operation than the right side (79.2% vs. 31.3%, P < 0.001). CT findings such as distant intraperitoneal air, pericolic air, and free fluid were significantly more apparent in the operation group. When these factors were evaluated in a multivariate analysis, distant intraperitoneal air showed statistical significance (P = 0.046) and pericolic air and left location a significant trend (P = 0.071 and P = 0.067, respectively).
Conclusion: This study suggests that distant intraperitoneal air is the most important factor in the need for surgery in patients with colonic diverticulitis. Further study will be able to identify more detailed CT findings and verify their significance, and will be helpful in designing practical scoring and classification systems.
Methods: Three hundred fifty-seven patients diagnosed with colonic diverticulitis from January 2010 to July 2016 were retrospectively evaluated. Patients were excluded if pure diverticulosis, diverticular bleeding, colon cancer, or relevant data deficiencies, and the remaining patients (n = 178) were reviewed. Patients were categorized into a successful nonoperation group and an operation group. The operation group was then matched 1:2 with the nonoperative group based on age, gender, American Society of Anesthesiologists physical status classification, and body mass index.
Results: After propensity score matching, there were no significant differences regarding patients’ demographic characteristics between the 2 groups. Left location was more associated with need for operation than the right side (79.2% vs. 31.3%, P < 0.001). CT findings such as distant intraperitoneal air, pericolic air, and free fluid were significantly more apparent in the operation group. When these factors were evaluated in a multivariate analysis, distant intraperitoneal air showed statistical significance (P = 0.046) and pericolic air and left location a significant trend (P = 0.071 and P = 0.067, respectively).
Conclusion: This study suggests that distant intraperitoneal air is the most important factor in the need for surgery in patients with colonic diverticulitis. Further study will be able to identify more detailed CT findings and verify their significance, and will be helpful in designing practical scoring and classification systems.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (23)
참고문헌 신청
[학술지(정기간행물)] - Kaiser AM / 2005 / The management of complicated diverticulitis and the role of computed tomography / Am J Gastroenterol 100 : 910 ~ 917
[학술지(정기간행물)] - Chabok A / 2012 / Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis / Br J Surg 99 : 532 ~ 539
[학술지(정기간행물)] - Klarenbeek BR / 2012 / Review of current classifications for diverticular disease and a translation into clinical practice / Int J Colorectal Dis 27 : 207 ~ 214
[학술지(정기간행물)] - Sher ME / 1997 / Laparoscopic surgery for diverticulitis / Surg Endosc 11 : 264 ~ 267
[학술지(정기간행물)] - Ambrosetti P / 2002 / Colonic diverticulitis: impact of imaging on surgical management -- a prospective study of 542 patients / Eur Radiol 12 : 1145 ~ 1149
[학술지(정기간행물)] - Chabok A / 2012 / Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis / Br J Surg 99 : 532 ~ 539
[학술지(정기간행물)] - Klarenbeek BR / 2012 / Review of current classifications for diverticular disease and a translation into clinical practice / Int J Colorectal Dis 27 : 207 ~ 214
[학술지(정기간행물)] - Sher ME / 1997 / Laparoscopic surgery for diverticulitis / Surg Endosc 11 : 264 ~ 267
[학술지(정기간행물)] - Ambrosetti P / 2002 / Colonic diverticulitis: impact of imaging on surgical management -- a prospective study of 542 patients / Eur Radiol 12 : 1145 ~ 1149
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