Radiologic predictors for failure of non-operative management of complicated diverticulitis: a single-centre cohort study.

Reischl, Stefan; Roehl, Kai Dominik; Ziegelmayer, Sebastian; Friess, Helmut; Makowski, Marcus Richard; Wilhelm, Dirk; Novotny, Alexander Rudolf; Gaa, Jochen; Neumann, Philipp-Alexander

doi:10.1007/s00423-021-02244-3

2021

Zurück
Zurück zum Anfang der Trefferliste
Dauerhafter Link zum angezeigten Objekt

Titel:: Radiologic predictors for failure of non-operative management of complicated diverticulitis: a single-centre cohort study.
Dokumenttyp:: Journal Article
Autor(en):: Reischl, Stefan; Roehl, Kai Dominik; Ziegelmayer, Sebastian; Friess, Helmut; Makowski, Marcus Richard; Wilhelm, Dirk; Novotny, Alexander Rudolf; Gaa, Jochen; Neumann, Philipp-Alexander
Abstract:: PURPOSE: Modern non-operative management of diverticulitis consists of a complex therapeutic regimen and is successful in most cases even of complicated diverticulitis. Still, a certain proportion of patients requires urgent surgery due to failure of the conservative approach. This study aims to identify predictors for failure of conservative treatment of complicated diverticulitis with the need for subsequent urgent resection during the acute episode. METHODS: A single-centre retrospective cohort study was performed at our tertiary centre including cases of acute complicated diverticulitis (characterized by localized abscess formation and/or pericolic air) between 2007 and 2019 that were treated guideline-conform by multimodal conservative treatment. Radiologic characteristics of disease in CT scans upon admission were analysed by uni- and multivariable logistic regression to determine predictors for resection within 30 days after onset of the conservative therapy approach. RESULTS: A total of 669 cases of acute diverticulitis were identified, of which 141 patients met the inclusion criteria. Overall, 13% (n = 19) of patients were operated within 30 days despite initial conservative management. Multivariable logistic regression identified length of inflamed bowel greater than 7 cm (p < 0.011) and abscess formations >1 cm (p < 0.001) as significant risk factors for failure of conservative treatment. CONCLUSION: Patients with length of inflamed bowel >7 cm or abscess formation >1 cm have increased risk for failure of conservative treatment of acute episodes of diverticulitis with contained perforations with subsequent need for urgent surgery. Therefore, conservative treatment of those patients should be monitored with special caution.
Zeitschriftentitel:: Langenbecks Arch Surg
Jahr:: 2021
Band / Volume:: 406
Heft / Issue:: 7
Seitenangaben Beitrag:: 2409-2418
Volltext / DOI:: doi:10.1007/s00423-021-02244-3
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/34189654
Print-ISSN:: 1435-2443
TUM Einrichtung:: Institut für Diagnostische und Interventionelle Radiologie; Klinik und Poliklinik für Chirurgie
BibTeX