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Erschienen in: European Surgery 6/2021

09.04.2021 | original article

Seeking outpatient management of right-sided diverticulitis

verfasst von: M.D. María Savoie-Hontoria, M.D, Ph. D. Rafael José Orti-Rodríguez, MSc. Miguel Ángel García Bello, M.D. Antonio Dámaso Pérez Álvarez, M.D. Manuel Ángel Barrera Gómez

Erschienen in: European Surgery | Ausgabe 6/2021

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Summary

Background

Right-sided colonic diverticulitis (RD) is much rarer than left-sided (LD) and controversies concerning the most appropriate treatment remain unsolved. Most Western centers treat RD with inpatient management independently of the severity of the disease. The aim of this study is to compare RD and LD patients who were treated as inpatients in order to define the RD patients who could benefit from outpatient management.

Methods

We performed a retrospective comparative study in which all acute diverticulitis patients admitted to our hospital from June 2015 to December 2019 were included. Clinical features, radiological findings, type of treatment, complications rate, and relapse time were analyzed in both groups.

Results

From a total of 239 patients, 24 patients with RD and 94 patients with LD were included. American Society of Anesthesiologists (ASA) classification was significantly lower in RD (p = 0.005). The presence of pneumoperitoneum in CT scan was significantly higher in LD (p = 0.001) and no RD patient required any kind of surgical intervention including percutaneous drainage. In contrast, 23.4% of LD patients needed a surgical procedure (p = 0.001). Third-line antibiotics of were only prescribed in left diverticulitis (p = 0.003). Length of hospital stay was significantly shorter in RD patients (p = 0.001).

Conclusion

Patients with right diverticulitis had fewer perforations, required lower-spectrum antibiotics, and did not require any surgical treatment, with a shorter length of hospital stay. Given these results, we consider that mild right diverticulitis could benefit from an outpatient treatment following similar recommendations to those followed for mild LD patients. This is one of the largest series in Western literature and the only one that compares clinical features, complication rates, and type of treatment between right and left diverticulitis. Outpatient management in RD is a feasible option which is not only safe but can also reduce costs.
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Metadaten
Titel
Seeking outpatient management of right-sided diverticulitis
verfasst von
M.D. María Savoie-Hontoria
M.D, Ph. D. Rafael José Orti-Rodríguez
MSc. Miguel Ángel García Bello
M.D. Antonio Dámaso Pérez Álvarez
M.D. Manuel Ángel Barrera Gómez
Publikationsdatum
09.04.2021
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 6/2021
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-021-00702-2