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Tytuł pozycji:

Subspecialist emergency management of diverticulitis is associated with reduced mortality and fewer stomas.

Tytuł :
Subspecialist emergency management of diverticulitis is associated with reduced mortality and fewer stomas.
Autorzy :
Boyce SA; Western General Hospital, Edinburgh University of Edinburgh, Edinburgh, UK. />Bartolo DC
Paterson HM
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Corporate Authors :
Edinburgh Coloproctology Unit
Źródło :
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2013 Apr; Vol. 15 (4), pp. 442-7.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Original Publication: Oxford, UK : Blackwell Science Ltd.,
MeSH Terms :
Colorectal Surgery*
Specialization*
Diverticulitis, Colonic/*surgery
Ileum/*surgery
Rectum/*surgery
Aged ; Anastomosis, Surgical/mortality ; Anastomosis, Surgical/statistics & numerical data ; Colectomy/mortality ; Colectomy/statistics & numerical data ; Diverticulitis, Colonic/mortality ; Diverticulitis, Colonic/therapy ; Emergencies ; Female ; Humans ; Ileostomy/mortality ; Ileostomy/statistics & numerical data ; Male ; Scotland/epidemiology
Grant Information :
MC_U127527198 United Kingdom Medical Research Council
Contributed Indexing :
Investigator: DN Anderson; DC Bartolo; MH Collie; MG Dunlop; KC Fearon; BJ Mander; MA Potter; C Reddy; RG Wilson; HM Paterson
Entry Date(s) :
Date Created: 20120913 Date Completed: 20131118 Latest Revision: 20170922
Update Code :
20201020
DOI :
10.1111/codi.12022
PMID :
22966859
Czasopismo naukowe
Aim: The aim of the study was to compare outcomes for emergency management of diverticulitis before and after the creation of a regional subspecialist colorectal unit.
Method: We retrieved data on all emergency admissions for diverticulitis from the regional surgical audit database and compared results before (January 1998 to August 2002) and after (August 2002 to December 2008) establishment of the subspecialist colorectal surgery unit in August 2002. Additional data were retrieved from electronic patient records. The primary outcome measures were mortality and rate of primary anastomosis following resection.
Results: There were 879 patients before and 1280 patients after subspecialization. Nonoperative management was undertaken in approximately 80% of cases. Total mortality fell from 3.3 to 1.5% (P = 0.008), attributable to reduced operative mortality (9.6 to 4.2%; P = 0.019). The primary anastomosis rate for all left colon resections increased from 50.3 to 77.9%; P < 0.0001. Stoma formation of any type fell from 46.6 to 27.7%; P < 0001).
Conclusion: Emergency management of diverticulitis by subspecialist colorectal surgeons is associated with low overall and operative mortality whilst safely achieving high rates of primary anastomosis.
(© 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.)

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