Surgical treatment of sigmoid diverticulitis.
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Appropriate surgical treatment of diverticulitis of the colon can result in a highly satisfactory proportion of permanent cures, with an operative mortality of 2 to 5 per cent. Colostomy is a valuable emergency procedure for the control of severe infection or the relief of obstruction but is not a satisfactory definitive treatment for the cure of diverticulitis. Definitive surgical treatment requires resection of the involved segment of colon. Three indications for surgical intervention in "uncomplicated" diverticulitis are: (1) continued or repeated attacks, (2) persistent deformity as seen by x-ray examination, and (3) persistent blood in the stools. Although a three-stage operation is usually considered a safer procedure, one-stage resections may be safely and satisfactorily employed in many instances.
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The disease of diverticulitis now is encountered with increasing frequency due to the increasing average age of our population. Low mortality following resection and anastomosis and the excellent results after this procedure have broadened the indications for operation in this disease. From 1942 to 1955, 160 such operations for diverticulitis of the sigmoid colon were carried out at the Massachusetts General Hospital with a mortality of 3 per cent. The results, except in the few cases where too conservative a resection was carried out and a secondary operation was necessary to produce a cure, have been excellent.
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