충수염 진단하에 개복 수술 중 발견한 맹장 게실염의 수술적 치료
Surgical Management of Cecal Diverticulitis Detected during Appendectomy
박철운, 김봉구, 김기상, 변영훈, 조광호, 변상현, 김병주,
소속 상세정보
박철운 ( Park Chul-Woon )
동수원병원 외과
김봉구 ( Kim Bong-Gu )
동수원병원 외과
김기상 ( Kim Ki-Sang )
동수원병원 외과
변영훈 ( Byun Young-Hoon )
동수원병원 외과
조광호 ( Jo Gwang-Ho )
동수원병원 외과
변상현 ( Byun Sang-Hyun )
동수원병원 외과
김병주 ( Kim Byung-Joo )
강남병원 일반외과
KMID : 0356720010170010015
Abstract
Purpose: Acute diverticulitis of the right colon is not rare in Korea and the clinical presentation is indistin guishable from acute appendicitis. Cecal diverticulitis has led to a controversy in the management of disease.
Methods: Thirty-one cases of acute cecal diverticulitis who underwent operation for suspected acute appendicitis were reviewed retrospectively from January 1995 to December 1998.
Results: There were 17 men & 14 women. Ages ranged from 9 to 69 (mean: 37.5) years. All patients presented with signs and symptoms as acute appendicitis. All patients were explored through a transverse incision in the right lower quadrant under the impression of acute appendicitis. An appendectomy and drainage was performed in 13 patients, and resection of the lesion was performed in 18 patients (12 ileocecal resection, one partial cecectomy including appendix, one partial cecectomy and an appendectomy, 4 diverticulectomy and appendectomy), depending on the location of diverticulitis, severity of inflammation, and surgeon. Staples (TA , GIA ) were used in all cecal resection cases except for diverticulectomy. Five complications were observed, 3 in cecal resection cases (one wound seroma, one wound infection and one bleeding), and 2 in appendectomy and drainage cases (two wound infections). There was no postoperative mortality. The average length of the postoperative stay was 10.2 days in the drainage group and 8.8 days in the cecal resection group. Two recurrences were observed. One was the patient who had diverticulectomy performed. The other was a patient who had had appendectomy and drainage.
Conclusion: We concluded that the preferred surgical management of an acute cecal diverticulitis operated for a presumed acute appendicitis is cecectomy using staples depending on its location and severity of inflammation. It was safe, relatively easy to do through the same incision, and could be a definitive treatment.
키워드
게실염;맹장절제;자동문합기
Cecal diverticulitis;Cecectomy;Stapler
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