대장게실증의 외과적 치료
Surgical Treatment of the Colonic Diverticulosis
장주희, 유창식, 조영규, 남궁환, 홍현기, 김희철, 김진천,
소속 상세정보
장주희 ( Chang Ju-Hee )
울산대학교 의과대학 외과학교실
유창식 ( Yu Chang-Sik )
울산대학교 의과대학 외과학교실
조영규 ( Cho Young-Kyu )
울산대학교 의과대학 외과학교실
남궁환 ( Namgung Hwan )
울산대학교 의과대학 외과학교실
홍현기 ( Hong Hyun-Ki )
울산대학교 의과대학 외과학교실
김희철 ( Kim Hee-Cheol )
울산대학교 의과대학 외과학교실
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
KMID : 0371320020620050415
Abstract
Purpose: In Asia including Korea, colonic diverticulosis is a relatively uncommon disease. Recently, the incidences of left colonic diverticulosis in Korea has been increasing, mainly due to a westernized diet and life-style. This study
was
performed to analyze the clinical manifestations and surgical outcomes of patients with colonic diverticulosis.
Methods: We retrospectively reviewed the medical records of 39 patients with colonic diverticulosis who underwent surgery at Asan Medical Center during July 1989 and December 2001.
Results: The male to female ratio was 30:9, and the mean age was 52 (26~78) years. The most prevalent age group was people in fifth decade (13 cases, 33%). Twenty-three cases (59%) were in the right colon, 14 cases (36%) in the left and 2
cases
(5%) were bilateral. The relative incidence of left colonic diverticulosis was higher in the elderly patients group (≥50 years old) (57% vs 15%; P=0.002). Of the three diagnostic tools, the barium enema showed a 63% accuracy, the colonofiberscopy
62%
and the abdomen-pelvic CT scan 59%. Bowel perforation (19 cases, 49%) and recurrent abdominal pain (10 cases, 16%) were the common surgical indications. Among 11 cases with bowel perforation accompanying the left colonic diverticulosis, two cases
(18%),
which underwent one-stage operation, developed complications, while 3 cases (27%) among the other 9 that underwent multi-staged operations, did so.
Conclusions: The incidences of left colonic diverticulosis were relatively high (36%), especially in the elderly patients (P= 0.002). This study indicates that a tailored surgical procedure, depending on the severity of inflammation, is
important
in reducing postoperative complications.
키워드
대장게실증; 수술; 합병증; Diverticulosis; Surgery; Complication;
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