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Article: Emergency surgery comparison of right versus left acute colonic diverticulitis: A 10-year outcome analysis

TitleEmergency surgery comparison of right versus left acute colonic diverticulitis: A 10-year outcome analysis
Authors
KeywordsRight colonic diverticulitis
Surgical outcome
Emergency surgery
Issue Date2021
PublisherElsevier Ltd. The Journal's web site is located at http://www.elsevier.com/locate/surgeon/
Citation
The Surgeon, 2021, v. 19 n. 3, p. 150-155 How to Cite?
AbstractIntroduction: The difference in outcome between right (RCD) and left colonic diverticulitis (LCD) is not well established. The aim of this study was to analyse the presentation and surgical outcome of RCD versus left-sided disease following emergency surgery. Method: We conducted a retrospective review of patients presenting with acute diverticulitis over a 10-year period from 2004 to 2014 to a tertiary unit. Patient demographics, Hinchey classification, need for emergency surgery, perioperative outcome and recurrence were evaluated. Results: In total 360 patients presented with acute diverticulitis, 218 (61%) were right-sided and 142 (39%) were left-sided. The mean age (57 yrs vs 68 yrs) and median length of stay (4 days vs 5 days) were significantly less in RCD (p < 0.001). The need for emergency surgery was similar between RCD and LCD (30.7% vs 23.2%, p = 0.12). Sixty-seven (31%) patients with RCD required emergency surgery, 42 (62.7%) of these were based on a presumptive diagnosis of appendicitis and underwent laparoscopic appendicectomy only. Operative morbidity (10.4% vs 51.5%, p < 0.001) and mortality were significantly higher in LCD (1.5% v 15.2%, p = 0.007). Subgroup analysis of non-appendicectomy, RCD patients, showed LCD were more likely to require surgery (11.5% vs 23.2%, p = 0.003). There was no difference in recurrence (p = 0.6). Conclusion: Right colonic diverticulitis patients are younger and disease course is more benign compared to LCD. Presentation can be confused with appendicitis without proper imaging. In the rare cases where emergency surgery is required, RCD is associated with a lower operative morbidity and mortality compared to left-sided disease.
Persistent Identifierhttp://hdl.handle.net/10722/286348
ISSN
2023 Impact Factor: 2.3
2023 SCImago Journal Rankings: 0.625
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTsang, JS-
dc.contributor.authorFoo, CC-
dc.contributor.authorYip, J-
dc.contributor.authorChoi, HK-
dc.contributor.authorLaw, WL-
dc.contributor.authorLo, OSH-
dc.date.accessioned2020-08-31T07:02:36Z-
dc.date.available2020-08-31T07:02:36Z-
dc.date.issued2021-
dc.identifier.citationThe Surgeon, 2021, v. 19 n. 3, p. 150-155-
dc.identifier.issn1479-666X-
dc.identifier.urihttp://hdl.handle.net/10722/286348-
dc.description.abstractIntroduction: The difference in outcome between right (RCD) and left colonic diverticulitis (LCD) is not well established. The aim of this study was to analyse the presentation and surgical outcome of RCD versus left-sided disease following emergency surgery. Method: We conducted a retrospective review of patients presenting with acute diverticulitis over a 10-year period from 2004 to 2014 to a tertiary unit. Patient demographics, Hinchey classification, need for emergency surgery, perioperative outcome and recurrence were evaluated. Results: In total 360 patients presented with acute diverticulitis, 218 (61%) were right-sided and 142 (39%) were left-sided. The mean age (57 yrs vs 68 yrs) and median length of stay (4 days vs 5 days) were significantly less in RCD (p < 0.001). The need for emergency surgery was similar between RCD and LCD (30.7% vs 23.2%, p = 0.12). Sixty-seven (31%) patients with RCD required emergency surgery, 42 (62.7%) of these were based on a presumptive diagnosis of appendicitis and underwent laparoscopic appendicectomy only. Operative morbidity (10.4% vs 51.5%, p < 0.001) and mortality were significantly higher in LCD (1.5% v 15.2%, p = 0.007). Subgroup analysis of non-appendicectomy, RCD patients, showed LCD were more likely to require surgery (11.5% vs 23.2%, p = 0.003). There was no difference in recurrence (p = 0.6). Conclusion: Right colonic diverticulitis patients are younger and disease course is more benign compared to LCD. Presentation can be confused with appendicitis without proper imaging. In the rare cases where emergency surgery is required, RCD is associated with a lower operative morbidity and mortality compared to left-sided disease.-
dc.languageeng-
dc.publisherElsevier Ltd. The Journal's web site is located at http://www.elsevier.com/locate/surgeon/-
dc.relation.ispartofThe Surgeon-
dc.subjectRight colonic diverticulitis-
dc.subjectSurgical outcome-
dc.subjectEmergency surgery-
dc.titleEmergency surgery comparison of right versus left acute colonic diverticulitis: A 10-year outcome analysis-
dc.typeArticle-
dc.identifier.emailTsang, JS: julianst@hku.hk-
dc.identifier.emailFoo, CC: ccfoo@hku.hk-
dc.identifier.emailYip, J: yipjeremy@hku.hk-
dc.identifier.emailChoi, HK: hkchoi@HKUCC-COM.hku.hk-
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hk-
dc.identifier.emailLo, OSH: oswens@hku.hk-
dc.identifier.authorityFoo, CC=rp01899-
dc.identifier.authorityYip, J=rp02304-
dc.identifier.authorityLaw, WL=rp00436-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.surge.2020.04.007-
dc.identifier.pmid32690462-
dc.identifier.scopuseid_2-s2.0-85088015072-
dc.identifier.hkuros313142-
dc.identifier.volume19-
dc.identifier.issue3-
dc.identifier.spage150-
dc.identifier.epage155-
dc.identifier.isiWOS:000666969500006-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1479-666X-

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