ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ, PHẪU THUẬT VÀ PHẪU THUẬT NỘI SOI VIÊM TÚI THỪA ĐẠI TRÀNG (81 TRƯỜNG HỢP)

Abstract

Study aim: 1. Evaluate the diagnosis of diverticulitis. 2.The result of medical management and laparoscopic -laparotomy surgery of colon diverticulitis. Patient and method: +Retrospective study. +Time: 2008-2013. Result: + Thers were 81 patients, male 60,5%, female 39,5%; mean age 45,14±18,5 (range:16-93 Y). Distribution: Urban area 65,4%, rural area 34,6%, Occupation concerned: Intellecture 48,2%, farmer 18,5%. Diagnosis: Right colon diverticulitis 77,8%, left colon diverticulitis 9,9; combination of right -left 12,3%. Abdominal CTScan performed in 84% with accuracy by 85,3%. Medical treatment: 48,1% with 100% success rate (Hinchey I classification). Average hospital duration (medical) 5,64±2,65 day, 84,6% had combination of 2 antibiotic drugs  therapy. Surgery: Operation performed in 51,9%;of them, emmergency surgery in 85,7%, elective in 14,3%; laparoscopic in 61,9%, laparotomy in 23,8%, conversion 14,3%. +Surgical procedure included: ++Laparoscpic surgery: Exploratory and appendectomy 73,2%, diverticulectomy 15,4%, cecostomy 3,8%,lavage and drainage 3,8%.Laparoscopic left colectomy 3,8%. ++Laparotomy and conversion to laparotomy: Right hemicolectomy 31,3% (5 of 16 patients), Left hemicolectomy 6,2%. Left and right colectomy 12,5%, Harmann procedure 18,8%. ++The average operation time: 93,8±55,2' (range 30-210'). Duration of hospital stay 7,2±4,04 day (3-25 d). ++Complication and death: 1 death on 2nd day post Hartmann procedure (diffusse peritonitis due to perforated left colon diveticulitis, respiratory failure). 8 patient had infected of abdominal incision, 1 had residual abscess treated by  CTScan guided drainage. Conclusion: We concluded that +The diverticulitis proportion: colon diverticulitis had  slightly prevalence in male 60,5%, mean age 45,14±18,5 Y. The Proportion of right colon diverticulitis was 77,8%, Left colon dievrticulitis 9,9%,Rght and left colon: 12,3%. + Abdominal CTScan is  diagnotic method with the accuracy of 85,3%. +Medical treatment: Success rate 100% (Hinchey I classification), average hospital stay 5,64±2,65 day, average duration of antibiotic drug therapy 5,1±2,36 day. +Surgery: 51,9%, of them emerency operation 85,7%; elective 14,3%. +Laparoscopic operation 61,9%, laparotomy 23,8%, coversion to laparotomy: 14,3%. +Average operating time 93,8±55,2 (30-210'). Surgical treatment  duration  7,2±4,04 day