Published online Oct 14, 2010. doi: 10.3748/wjg.v16.i38.4854
Revised: June 7, 2010
Accepted: June 14, 2010
Published online: October 14, 2010
AIM: To compare the recurrence rate following initial antibiotic management to that following laparoscopic treatment for suspected uncomplicated cecal diverticulitis.
METHODS: We examined the records of 132 patients who were diagnosed with uncomplicated cecal diverticulitis and a first attack during an 8-year period. The diagnosis of uncomplicated diverticulitis was made based on imaging findings, such as inflamed diverticulum or a phlegmon with cecal wall thickening. Concurrent appendiceal dilatation from 8 to 12 mm was observed in 36 patients (27%). One hundred and two patients were treated initially with antibiotics only, whereas 30 underwent laparoscopic treatment, including partial cecectomy (n = 8) or appendectomy with diverticulectomy (n = 9) or appendectomy alone (n = 13). We compared clinical outcomes in both groups over a median follow-up period of 46 mo.
RESULTS: All patients were successfully treated with initial therapy. Of the 102 patients who initially received only antibiotic treatment, 6 (6%) had a recurrence (3 in the cecum and 3 in the ascending colon or transverse colon) during the follow-up period. Five of these patients were managed with repeated antibiotic treatment and 1 underwent ileocolic resection for perforation. Of the 30 patients treated by the laparoscopic approach, 2 (7%) had a recurrence (ascending colon) which was treated with antibiotics.
CONCLUSION: Initial antibiotic management for suspected uncomplicated cecal diverticulitis showed comparable efficacy to laparoscopic treatment in the prevention of recurrence.