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Is Conservative Treatment with Antibiotics the Correct Strategy for Management of Right Colonic Diverticulitis?: A Prospective Study

대한대장항문학회지 2011년 27권 4호 p.188 ~ 193
 ( Kim Tae-Jung ) - Catholic University School of Medicine Department of Surgery

 ( Lee In-Kyu ) - Catholic University School of Medicine Department of Surgery
 ( Park Jong-Kyung ) - Catholic University School of Medicine Department of Surgery
 ( Lee Yoon-Suk ) - Catholic University School of Medicine Department of Surgery
 ( Si-Youn ) - Catholic University School of Medicine Department of Surgery
 ( Jung Hun ) - Catholic University School of Medicine Department of Surgery
 ( Kim Hyung-Jin ) - Catholic University School of Medicine Department of Surgery
 ( Lee Sang-Chul ) - Catholic University School of Medicine Department of Surgery
 ( Cheung Dae-Young ) - Catholic University School of Medicine Department of Internal Medicine
 ( Gorden D. Lee ) - USA Vanderbilt University Medical Center Department of Surgery
 ( Oh Seung-Taek ) - Catholic University School of Medicine Department of Surgery

Abstract


Purpose: The goals of this study were to identify whether conservative treatment with antibiotics in right colonic diverticulitis (RCD) patients, our empirical method used until now, is adequate and to determine how the natural history of RCD is affected by conservative treatment.

Methods: This study was designed as a case-control study. Group I was comprised of 12 patients who were managed conservatively, and clinical data were retrospectively collected. In group II, a total of 49 patients, diagnosed by using diagnostic criteria for RCD and managed conservatively, were prospectively included.

Results: The period of fasting was 2.7 days, and the hospital stay was 4.6 days in all patients. The intravenous and the oral antibiotic periods were 3.8 days and 9.8 days, respectively. There were no statistically significant differences in treatment results between the two groups except the duration of fasting and the hospitalization, and there were no complications under conservative treatment. Eight patients (13.1%) had recurrent diverticulitis during the follow-up period. The recurrence risk showed no significant difference between the groups. The RCD-free period after management was 60.1 months, and patients with recurrent RCD were treated by conservative treatment or laparoscopic surgery.

Conclusion: Conservative treatment with antibiotics is the optimal treatment of choice for RCD and shows no increase in complications.

키워드

Diverticulitis;Colon;Ascending;Medical management
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