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Diverticulitis of the Colon: Recent Surgical Experiences

Diverticulitis of the Colon: Recent Surgical Experiences Abstract The surgical management of patients with diverticulitis of the colon has changed from late treatment of dire complications toward progressive earlier resection in those failing to respond to medical therapy.1,2 This transition has occurred with advances in intestinal antisepsis3 as well as proper application of measures which make the older patient a better surgical risk. Factors which assume importance in this change include improved anesthesia, the better use of blood replacement, more understanding of electrolytes and body fluids, advances in surgical judgment, and technical improvements in the care of these patients.4,5 Stage procedures are decreasing in frequency to one-stage resection with primary anastomosis, and this has been shown to be a safe procedure yielding good results.6-8 Stage procedures are necessary, however, when patients with complications of diverticulitis are seen late and when the surgeon expects a high operative mortality rate. A study of patients with diverticulitis References 1. Ransom, H. K.: Diverticulitis of Colon , Gastroenterology 26:12-22, 1954. 2. Judd, E. S., and Smith, M. P.: Present Trends in Surgical Treatment of Diverticulitis , Surg Clin N Amer 37:1019-1027, 1957. 3. Jew, E. W., Jr., and Harbison, S. P.: Resection for Diverticular Disease of the Sigmoid Colon , Arch Surg 81:435-443, 1960.Crossref 4. Allen, J. G.; Harkins, H. N.; Moyer, C. S.; and Rhoads, J. E.: Surgery Principles and Practice , Philadelphia: J. P. Lippincott Company, 1957. 5. Cole, W. H.: Textbook of Surgery , New York: Appleton-Century-Crofts, Inc., 1959. 6. Colcock, B. P.: Surgical Management of Diverticulitis , Surg Gynec Obstet 102:721-728, 1956. 7. Moore, R. M., and Kirksey, O. T., Jr.: One-Stage Resection in Selected Cases of Sigmoid Diverticulitis , Ann Surg 139:826-832, 1954.Crossref 8. Waugh, J. M., and Walt, A. J.: An Appraisal of One Stage Anterior Resection in Diverticulitis of the Sigmoid Colon , Surg Gynec Obstet 104:690-698, 1957. 9. Welch, C. E.: Diverticulitis of the Colon , Amer J Gastroent 29:374-383, 1958. 10. Cohn, I., Jr.: Recent Developments in Colon Surgery , Surgery 46:638-650, 1959. 11. Welch, C. E.; Allen, A. W.; and Donaldson, G. A.: Appraisal for Resection of the Colon for Diverticulitis of the Sigmoid , Ann Surg 138:332-343 ( (Sept) ) 1953.Crossref 12. Kocour, E. J.: Diverticulitis of the Colon: Its Incidence in 7,000 Consecutive Autopsies With Reference to Its Complications , Amer J Surg 37:433-436, 1937.Crossref 13. McGowan, F. J., and Wolff, W. I.: Diverticulitis of the Sigmoid Colon , Gastroenterology 21: 119-132, 1952. 14. Schlicke, C. P., and Logan, A. H.: Surgical Treatment of Diverticulitis of the Colon , JAMA 169:1019-1024, 1959.Crossref 15. Debray, C.; Hardouin, J. P.; Besancon, F.; and Raimbault, J.: Incidence of Diverticulosis of the Colon According to Age , Sem Hop Paris 37: 1743-1745, 1961. 16. Pemberton, J. de J.; Black, B. M.; and Maino, C. R.: Progress in the Surgical Management of Diverticulitis of the Sigmoid Colon , Surg Gynec Obstet 85:523-534 ( (Oct) ) 1947. 17. Wagner, D. E., and Zollinger, R. W.: Diverticulitis of the Cecum and Ascending Colon , Arch Surg 83:436-443, 1961.Crossref 18. Rodkey, G. V., and Welch, C. E.: " Diverticulitis and Diverticulosis of the Colon ," in Turell, R.: Diseases of the Colon and Anorectum , Philadelphia: W. B. Saunders Co., 1959, vol 2, chap 32, p 633. 19. Ponka, J. L.; Fox, J. P.; and Brush, B. E.: Differential Diagnosis of Carcinoma of the Sigmoid and Diverticulitis: Evaluation of Aids , JAMA 172: 515-519, 1960.Crossref 20. Colcock, B. P., and Sass, R. E.: Diverticulitis and Carcinoma of Colon: Differential Diagnosis , Surg Gynec Obstet 99:627, 1954. 21. Madden, J. L., and Tan, Y. T.: Primary Resection and Anastomosis in the Treatment of Perforated Lesions of the Colon, with Abscess or Diffusing Peritonitis , Surg Gynec Obstet 113:646-650, 1961. 22. Ryan, P.: Emergency Resection and Anastomosis for Perforated Sigmoid Diverticulitis , Brit J Surg 45:611-616, 1958.Crossref 23. Noer, R. J.: Hemorrhage as a Complication of Diverticulitis , Ann Surg 141:674-685, 1955.Crossref 24. Quinn, W. C., and Ochsner, A.: Bleeding as a Complication of Diverticulosis or Diverticulitis of the Colon , Amer Surg 19:397-402, 1953. 25. Quinn, W. C.: Diverticular Disease of the Colon With Hemorrhage: A Study of 78 Cases , Amer Surg 26:171-174, 1960. 26. Welch, C. E.: Diverticulitis of the Colon , Amer J Gastroent 29:374-383, 1958. 27. Noer, R. J.; Hamilton, J. E.; Williams, D. J.; and Broughton, D. S.: Rectal Hemorrhage: Moderate and Severe , Ann Surg 155:794-805, 1962.Crossref 28. Babcock, W. W.: Advances in Operative Treatment of Cancer of Large Bowel , J Int Coll Surg 9:179-187, 1946. 29. McGregor, R. A., and Bacon, H. E.: Diverticular Disease of the Colon , Dis Colon Rectum 1:197-204, 1958.Crossref 30. Greene, W. W.: Diverticulitis of the Colon: Radical vs Conservative Treatment , Amer J Surg 94:282-289, 1957.Crossref 31. Colcock, B. P.: Surgical Management of Complicated Diverticulitis , New Engl J Med 259: 570-573, 1958.Crossref 32. Waugh, J. M.: Surgical Management of Diverticulitis of the Colon , Proc Mayo Clin 36:489-491, 1961. 33. Ransom, H. K.: Treatment of Diverticulitis of the Colon: Choice of Operation , Amer J Surg 92:672-677, 1956.Crossref 34. Ponka, J. L.; Fox, J. D.; and Brush, B. E.: Coexisting Carcinoma and Diverticula of the Colon: A Review of 355 Cases of Carcinoma of the Colon , AMA Arch Surg 79:373-384, 1959.Crossref 35. Judd, E. S., and Leigh, J. E.: Diverticulitis of the Colon; Recurrence After Apparently Adequate Segmental Resection, read before the meeting of Association for Surgery of the Alimentary Tract, June, 1961. 36. Allen, A. W.: Surgery of Diverticulitis of Colon , Amer J Surg 86:545-548, 1953.Crossref 37. Mayo, C. W., and Delaney, L. T., Jr.: Colonic Diverticulitis Associated With Carcinoma: A Review of 50 Cases , AMA Arch Surg 72:957-961, 1956.Crossref 38. Morton, D., and Goldman, L.: Differential Diagnostic Features of Neoplasm and Diverticulitis of Sigmoid Colon, read before the meeting of Association for Surgery of the Alimentary Tract, June, 1961. 39. Welch, C. E., and Rodkey, G. V.: Methods of Therapy in Diverticulitis , Surgery 39:712-724, 1956. 40. Cole, W. H.; Packard, D.; and Southwick, H. W.: Carcinoma of the Colon With Special Reference to Prevention of Recurrence , JAMA 155:1549-1553, 1954.Crossref 41. Colcock, B. P.: Surgical Treatment of Diverticulitis , Amer Surg 24:738-737, 1958. 42. Smithwick, R. H.: Surgical Treatment of Diverticulitis of the Sigmoid , Amer J Surg 99:192-205, 1960.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Diverticulitis of the Colon: Recent Surgical Experiences

Archives of Surgery , Volume 86 (5) – May 1, 1963

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Publisher
American Medical Association
Copyright
Copyright © 1963 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1963.01310110061009
Publisher site
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Abstract

Abstract The surgical management of patients with diverticulitis of the colon has changed from late treatment of dire complications toward progressive earlier resection in those failing to respond to medical therapy.1,2 This transition has occurred with advances in intestinal antisepsis3 as well as proper application of measures which make the older patient a better surgical risk. Factors which assume importance in this change include improved anesthesia, the better use of blood replacement, more understanding of electrolytes and body fluids, advances in surgical judgment, and technical improvements in the care of these patients.4,5 Stage procedures are decreasing in frequency to one-stage resection with primary anastomosis, and this has been shown to be a safe procedure yielding good results.6-8 Stage procedures are necessary, however, when patients with complications of diverticulitis are seen late and when the surgeon expects a high operative mortality rate. A study of patients with diverticulitis References 1. Ransom, H. K.: Diverticulitis of Colon , Gastroenterology 26:12-22, 1954. 2. Judd, E. S., and Smith, M. P.: Present Trends in Surgical Treatment of Diverticulitis , Surg Clin N Amer 37:1019-1027, 1957. 3. Jew, E. W., Jr., and Harbison, S. P.: Resection for Diverticular Disease of the Sigmoid Colon , Arch Surg 81:435-443, 1960.Crossref 4. Allen, J. G.; Harkins, H. N.; Moyer, C. S.; and Rhoads, J. E.: Surgery Principles and Practice , Philadelphia: J. P. Lippincott Company, 1957. 5. Cole, W. H.: Textbook of Surgery , New York: Appleton-Century-Crofts, Inc., 1959. 6. Colcock, B. P.: Surgical Management of Diverticulitis , Surg Gynec Obstet 102:721-728, 1956. 7. Moore, R. M., and Kirksey, O. T., Jr.: One-Stage Resection in Selected Cases of Sigmoid Diverticulitis , Ann Surg 139:826-832, 1954.Crossref 8. Waugh, J. M., and Walt, A. J.: An Appraisal of One Stage Anterior Resection in Diverticulitis of the Sigmoid Colon , Surg Gynec Obstet 104:690-698, 1957. 9. Welch, C. E.: Diverticulitis of the Colon , Amer J Gastroent 29:374-383, 1958. 10. Cohn, I., Jr.: Recent Developments in Colon Surgery , Surgery 46:638-650, 1959. 11. Welch, C. E.; Allen, A. W.; and Donaldson, G. A.: Appraisal for Resection of the Colon for Diverticulitis of the Sigmoid , Ann Surg 138:332-343 ( (Sept) ) 1953.Crossref 12. Kocour, E. J.: Diverticulitis of the Colon: Its Incidence in 7,000 Consecutive Autopsies With Reference to Its Complications , Amer J Surg 37:433-436, 1937.Crossref 13. McGowan, F. J., and Wolff, W. I.: Diverticulitis of the Sigmoid Colon , Gastroenterology 21: 119-132, 1952. 14. Schlicke, C. P., and Logan, A. H.: Surgical Treatment of Diverticulitis of the Colon , JAMA 169:1019-1024, 1959.Crossref 15. Debray, C.; Hardouin, J. P.; Besancon, F.; and Raimbault, J.: Incidence of Diverticulosis of the Colon According to Age , Sem Hop Paris 37: 1743-1745, 1961. 16. Pemberton, J. de J.; Black, B. M.; and Maino, C. R.: Progress in the Surgical Management of Diverticulitis of the Sigmoid Colon , Surg Gynec Obstet 85:523-534 ( (Oct) ) 1947. 17. Wagner, D. E., and Zollinger, R. W.: Diverticulitis of the Cecum and Ascending Colon , Arch Surg 83:436-443, 1961.Crossref 18. Rodkey, G. V., and Welch, C. E.: " Diverticulitis and Diverticulosis of the Colon ," in Turell, R.: Diseases of the Colon and Anorectum , Philadelphia: W. B. Saunders Co., 1959, vol 2, chap 32, p 633. 19. Ponka, J. L.; Fox, J. P.; and Brush, B. E.: Differential Diagnosis of Carcinoma of the Sigmoid and Diverticulitis: Evaluation of Aids , JAMA 172: 515-519, 1960.Crossref 20. Colcock, B. P., and Sass, R. E.: Diverticulitis and Carcinoma of Colon: Differential Diagnosis , Surg Gynec Obstet 99:627, 1954. 21. Madden, J. L., and Tan, Y. T.: Primary Resection and Anastomosis in the Treatment of Perforated Lesions of the Colon, with Abscess or Diffusing Peritonitis , Surg Gynec Obstet 113:646-650, 1961. 22. Ryan, P.: Emergency Resection and Anastomosis for Perforated Sigmoid Diverticulitis , Brit J Surg 45:611-616, 1958.Crossref 23. Noer, R. J.: Hemorrhage as a Complication of Diverticulitis , Ann Surg 141:674-685, 1955.Crossref 24. Quinn, W. C., and Ochsner, A.: Bleeding as a Complication of Diverticulosis or Diverticulitis of the Colon , Amer Surg 19:397-402, 1953. 25. Quinn, W. C.: Diverticular Disease of the Colon With Hemorrhage: A Study of 78 Cases , Amer Surg 26:171-174, 1960. 26. Welch, C. E.: Diverticulitis of the Colon , Amer J Gastroent 29:374-383, 1958. 27. Noer, R. J.; Hamilton, J. E.; Williams, D. J.; and Broughton, D. S.: Rectal Hemorrhage: Moderate and Severe , Ann Surg 155:794-805, 1962.Crossref 28. Babcock, W. W.: Advances in Operative Treatment of Cancer of Large Bowel , J Int Coll Surg 9:179-187, 1946. 29. McGregor, R. A., and Bacon, H. E.: Diverticular Disease of the Colon , Dis Colon Rectum 1:197-204, 1958.Crossref 30. Greene, W. W.: Diverticulitis of the Colon: Radical vs Conservative Treatment , Amer J Surg 94:282-289, 1957.Crossref 31. Colcock, B. P.: Surgical Management of Complicated Diverticulitis , New Engl J Med 259: 570-573, 1958.Crossref 32. Waugh, J. M.: Surgical Management of Diverticulitis of the Colon , Proc Mayo Clin 36:489-491, 1961. 33. Ransom, H. K.: Treatment of Diverticulitis of the Colon: Choice of Operation , Amer J Surg 92:672-677, 1956.Crossref 34. Ponka, J. L.; Fox, J. D.; and Brush, B. E.: Coexisting Carcinoma and Diverticula of the Colon: A Review of 355 Cases of Carcinoma of the Colon , AMA Arch Surg 79:373-384, 1959.Crossref 35. Judd, E. S., and Leigh, J. E.: Diverticulitis of the Colon; Recurrence After Apparently Adequate Segmental Resection, read before the meeting of Association for Surgery of the Alimentary Tract, June, 1961. 36. Allen, A. W.: Surgery of Diverticulitis of Colon , Amer J Surg 86:545-548, 1953.Crossref 37. Mayo, C. W., and Delaney, L. T., Jr.: Colonic Diverticulitis Associated With Carcinoma: A Review of 50 Cases , AMA Arch Surg 72:957-961, 1956.Crossref 38. Morton, D., and Goldman, L.: Differential Diagnostic Features of Neoplasm and Diverticulitis of Sigmoid Colon, read before the meeting of Association for Surgery of the Alimentary Tract, June, 1961. 39. Welch, C. E., and Rodkey, G. V.: Methods of Therapy in Diverticulitis , Surgery 39:712-724, 1956. 40. Cole, W. H.; Packard, D.; and Southwick, H. W.: Carcinoma of the Colon With Special Reference to Prevention of Recurrence , JAMA 155:1549-1553, 1954.Crossref 41. Colcock, B. P.: Surgical Treatment of Diverticulitis , Amer Surg 24:738-737, 1958. 42. Smithwick, R. H.: Surgical Treatment of Diverticulitis of the Sigmoid , Amer J Surg 99:192-205, 1960.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1963

References