caa a22 4500 475791223 CHVBK 20180406123711.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s004230050257 doi (NATIONALLICENCE)springer-10.1007/s004230050257 Evidence-based surgery: diverticulitis - a surgical disease? [Elektronische Daten] [E. H. Farthmann, K. D. Rückauer, R. U. Häring] Abstract : Sigmoid diverticulitis is an increasingly common disorder. While there is no gender difference, the incidence increases with age. Many reports have been published on the topic, but there is no consensus on certain aspects of treatment. We conducted a literature search covering the past 30 years and report our own data. Two major areas of controversy exist. One concerns indications for elective surgery for symptomatic diverticulitis. The consensus is that there is no indication for prophylactic surgery. The first attack should be treated conservatively; elective surgery is considered following a second attack, but in immunocompromised patients earlier. The second controversy concerns surgical strategy in peritonitis from perforation. Three-stage operations have generally been abandoned. The question is whether to perform a sigmoid resection with primary anastomosis. One end of the spectrum is recent perforation which can be treated safely by resection and anastomosis. The other end is advanced feculent peritonitis in high-risk patients. In this situation a Hartmann procedure is recommended. Although data from prospective randomized studies are lacking, there seem to be indicators in the individual situation that allow a rational selection of the appropriate procedure. Diverticulitis can thus be treated surgically for a broad range of its forms of presentation. Springer-Verlag Berlin Heidelberg, 2000 Key words Diverticulitis nationallicence Peritonitis nationallicence Sigmoid resection nationallicence Elective operation nationallicence Emergency surgery nationallicence Farthmann E. H. Department of General Surgery, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany e-mail: haering@ch11.ukl.uni-freiburg.de Tel.: +49-761-2702644 Fax: +49-761-2702804, DE aut Rückauer K. D. Department of General Surgery, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany e-mail: haering@ch11.ukl.uni-freiburg.de Tel.: +49-761-2702644 Fax: +49-761-2702804, DE aut Häring R. U. Department of General Surgery, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany e-mail: haering@ch11.ukl.uni-freiburg.de Tel.: +49-761-2702644 Fax: +49-761-2702804, DE aut https://doi.org/10.1007/s004230050257 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230050257 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Farthmann E. H. Department of General Surgery, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany e-mail: haering@ch11.ukl.uni-freiburg.de Tel.: +49-761-2702644 Fax: +49-761-2702804, DE aut NATIONALLICENCE 700 1- Rückauer K. D. Department of General Surgery, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany e-mail: haering@ch11.ukl.uni-freiburg.de Tel.: +49-761-2702644 Fax: +49-761-2702804, DE aut NATIONALLICENCE 700 1- Häring R. U. Department of General Surgery, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany e-mail: haering@ch11.ukl.uni-freiburg.de Tel.: +49-761-2702644 Fax: +49-761-2702804, DE aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer