Efectos Adversos en el Tratamiento de la Enfermedad Diverticular Complicada

Prospective multicentre evaluation of adverse outcomes following treatment for complicated diverticular disease British Journal of Surgery(p.1503-1513)
V. A. Constantinides, P. P. Tekkis, A. Senapati, on behalf of the Association of Coloproctology of Great Britain Ireland

Abstract
The choice of operation for complicated diverticular disease is contentious. The aim of this study was to investigate adverse events following restorative (primary resection and anastomosis, PRA) and non-restorative (Hartmann's procedure, HP) surgery for complicated diverticular disease.Five hundred and thirty-nine patients who presented with complicated diverticular disease in 42 centres over a 12-month period from January 2003 were considered for the study. Data were collected prospectively from 248 patients (46·0 per cent) who underwent PRA and 167 (31·0 per cent) who had HP. A propensity score was developed for case-mix adjustment. Multifactorial logistic regression was used to evaluate differences in operative outcomes.Mortality, surgical and medical complication rates were 4·0, 31·0 and 13·7 per cent respectively after PRA, and 23·4, 53·3 and 40·7 per cent for HP (all P < alt="chi" src="http://www3.interscience.wiley.com/giflibrary/10/chi.gif" border="0">2 = 8·31, 1 d.f., P = 0·004).PRA with or without a proximal diversion is more often performed non-electively by specialist colorectal surgeons. It may be a safe procedure for complicated diverticular disease in selected patients as it may be associated with fewer postoperative adverse events.