Abstract:
PURPOSE:It is controversial whether patients fare better with conservative or surgical treatment in certain stages of acute diverticulitis (AD), in particular when phlegmonous inflammation or covered micro- or macro-perforation are present. The aim of this study was to determine long-term quality of life (QoL) for AD patients who received either surgery or conservative treatment in different stages. METHODS:We included patients treated for AD at the University Hospital Grosshadern, Munich, Germany, between January 1, 2000, and December 31, 2010. Patients were classified by the Hansen and Stock (HS) classification, the modified Hinchey classification, and the German classification of diverticular disease (CDD). Pre-therapeutic staging was based on multidetector computed tomography. Long-term QoL was assessed by the Cleveland Global Quality of Life (CGQL) questionnaire, the Short Form 36 (SF-36), and the Gastrointestinal Quality of Life Index (GIQLI). Data are mean ± SEM. RESULTS:Patients with phlegmonous AD (HS type 2a, Hinchey Ia and CDD 1b, respectively) had a better long-term QoL on the GIQLI when they were operated (78.5 ± 2.5 vs. 70.7 ± 2.1; p < 0.05). Patients with micro-abscess (CDD 2a) had a better long-term QoL on the GIQLI, CGQL, and the "Role Physical" scale of the SF-36 when they were not operated (GIQLI 86.9 ± 2.1 vs. 76.8 ± 1.0; p = 0.10; CGQL 82.8 ± 5.1 vs. 65.3 ± 11.0; p = 0.08; SF-36/Role Physical 100 ± 0.0 vs. 41.7 ± 13.9; p < 0.001). Patients with macro-abscess (CDD 2b) had a better long-term QoL when they were operated (GIQLI 89.3 ± 1.4 vs. 69.5 ± 4.5; p < 0.01; CGQL 80.3 ± 7.6 vs. 60.5 ± 5.8; p < 0.05; SF-36/Role Physical 95.8 ± 4.2 vs. 47.9 ± 13.6; p < 0.001). CONCLUSION:Considering long-term QoL, phlegmonous AD (HS type 2a, Hinchey Ia and CDD 1b, respectively) should be treated conservatively. In patients with covered perforation, abscess size should guide the decision on whether to perform surgery later on or not. In the light of long-term quality of life, patients fare better after elective sigmoid colectomy when abscess size exceeds 1 cm.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Brandlhuber M,Genzinger C,Brandlhuber B,Sommer WH,Müller MH,Kreis MEdoi
10.1007/s00384-018-2969-ysubject
Has Abstractpub_date
2018-03-01 00:00:00pages
317-326issue
3eissn
0179-1958issn
1432-1262pii
10.1007/s00384-018-2969-yjournal_volume
33pub_type
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
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abstract:BACKGROUND:Laparoscopic resection for the cure of rectal cancer is still a matter of debate. Laparoscopic approach is more complex and with a long learning curve, which may results in an increase in morbidity and mortality. This study aimed to retrospectively analyze the impact of laparoscopic resection for rectal canc...
journal_title:International journal of colorectal disease
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abstract:BACKGROUND:Ostomies are being placed in 35 % of patients after colorectal cancer surgery. As decision-making regarding colorectal surgery is challenging in the older patients, it is important to have insight in the potential impact due to ostomies. METHODS:An internet-based survey was sent to all members with register...
journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
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abstract:PURPOSE:Some recent studies have suggested that fluorescence angiography with indocyanine green (ICG) might be useful for preventing anastomotic leakage (AL) after laparoscopic colorectal surgery. However, its efficacy has not been proven. We evaluated whether intraoperative ICG fluorescence angiography could decrease ...
journal_title:International journal of colorectal disease
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abstract::The authors of the published version of this article inadvertently omitted the table note of the Table 2 under the Appendix section. The complete Table 2 is shown in this article]. ...
journal_title:International journal of colorectal disease
pub_type: 已发布勘误
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abstract:PURPOSE:Subtotal colectomy (STC) is performed for severe acute and refractory colitis. The diagnosis can be difficult even after the surgery when colectomy specimen has overlapping features of ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to evaluate the rate of postoperative diagnostic re...
journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
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abstract:BACKGROUND:Colorectal cancer (CRC) is the third most common malignant neoplasm worldwide and the fourth leading cause of cancer-related deaths. This article reviews the epidemiology, risk factors, pathogenesis, and prognosis of CRC with special emphasis on advances in the management of CRC over the past decade. METHOD...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
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journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
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abstract:BACKGROUND AND AIMS:Photodynamic therapy (PDT) is a new treatment modality for early esophageal neoplasia. With two absorption maxima in the visible light range (550 and 588 nm) hypericin is a very promising photosensitizer for PDT with incoherent light sources. We studied the effects of photosensitizing hypericin in b...
journal_title:International journal of colorectal disease
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doi:10.1007/s00384-002-0440-5
更新日期:2003-05-01 00:00:00
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journal_title:International journal of colorectal disease
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更新日期:2013-10-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-007-0362-3
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Endoscopic polypectomy still remains the cornerstone of therapy for colorectal polyps and adenomas. However, if colorectal polyps are too large or not accessible for endoscopic ablation or cannot be removed without an increased risk for perforation, operative procedures are required. In such circums...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-010-0974-x
更新日期:2010-08-01 00:00:00
abstract::Twenty-two patients treated for rectal trauma between 1975 and 1985 were reviewed. There were 13 males and nine females, of mean age 38 years (18-72 years). Causes included gunshot (2), sexual trauma (8), road accident (5), impalement (5), polypectomy (2). Two patients died, giving a treatment mortality of 9%. Cases w...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF01648441
更新日期:1986-07-01 00:00:00
abstract:PURPOSE:Dendritic cell (DC)-based cancer vaccine represents a promising immunotherapy against cancer. There has been recent evidence which have suggested that toll-like receptor (TLR) ligands may be critical for DC preparation; this was usually omitted in the past. Our study is designed to investigate if the vaccinatio...
journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840050198
更新日期:1999-04-01 00:00:00
abstract:INTRODUCTION:When severe chronic pelvic pain, constipation, and bloating are due to dense pelvic adhesions fixing the sigmoid loops, patients may be offered the option of sigmoid colectomy. This study examines the effectiveness of colectomy in the treatment of such patients. METHODS:Patients were identified from a sur...
journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
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更新日期:2013-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:International journal of colorectal disease
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更新日期:2012-11-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析,评审
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
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更新日期:2020-03-01 00:00:00
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journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00342463
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journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
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abstract:BACKGROUND AND AIMS:Pouchitis is the major long-term complication after ileal pouch-anal anastomosis (IPAA) in patients operated on for ulcerative colitis. The cause is unknown, but both the history of ulcerative colitis and increased bacterial concentration are important factors. Chemokines are mediators for the recru...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
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