Population-based incidence of complicated diverticular disease of the sigmoid colon based on gender and age
Population-based incidence of complicated diverticular disease of the sigmoid colon based on gender and age
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DOI：
10.1007/s10350-004-7288-4
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发表时间：
2003-08-01
影响因子：
3.9
通讯作者：
Wolff, BG
中科院分区：
文献类型：
--
作者：
McConnell, EJ;Tessier, DJ;Wolff, BG
目的：本研究的目的是描述需要手术的临床症状性乙状结肠憩室病患者的性别和年龄差异。研究方法：回顾1988年1月至1998年1月间因憩室病需行乙状结肠切除术而住院的所有手术患者。结果：共收治934例因憩室病需要手术切除的患者。有443名男性和491名女性，平均年龄为64岁。49例患者出现直肠大出血（男性，3.6%;女性，1.6%），329例慢性憩室炎（男性，15.8%;女性，19.3%），61例有阻塞性症状（男性，2.7%;女性，3.9%），148人患有瘘管（男性，8.0%;女性，7.8%），170例穿孔（男性，8.7%;女性，9.4%），脓肿79例（男性，4.0%;女性，4.5%），59例狭窄急性憩室炎39例（男2.2%、女1.9%）。总体而言，50岁以下的患者更常表现为慢性或复发性憩室炎。结论：女性患者出现需要手术的并发症的时间平均比男性晚5年。总体而言，男性出血发生率较高（P=0.015），而女性更常出现狭窄和梗阻（P=0.02）。年轻男性更多地出现瘘管（P=0.03），而老年男性则出现出血（P=0.001）。年轻女性出现穿孔（P=0.002），老年女性出现慢性憩室炎（P=0.04）和狭窄（P=0.04）。
Purpose: The purpose of this study was to characterize the gender and age differences in patients with clinically symptomatic sigmoid diverticular disease requiring surgery. Methods: All surgical patients hospitalized with proven diverticular disease requiring sigmoid resection from January 1988 to January 1998 were reviewed. Results: A total of 934 patients requiring surgical resection for diverticular disease were admitted. There were 443 men and 491 women with an average age of 64. Forty-nine patients presented with massive rectal bleeding (males, 3.6 percent; females, 1.6 percent), 329 with chronic diverticulitis (males, 15.8 percent; females, 19.3 percent), 61 with obstructive symptoms (males, 2.7 percent; females, 3.9 percent), 148 with fistulas (males, 8.0 percent; females, 7.8 percent), 170 with perforation (male, 8.7 percent; female, 9.4 percent), 79 with abscess (males, 4.0 percent; females, 4.5 percent), 59 with stricture (males, 2.2 percent; females, 4.0 percent), and 39 with acute diverticulitis (males, 2.2 percent; females, 1.9 percent). Overall, patients younger than 50 presented more often with chronic or recurrent diverticulitis. Conclusions: Female patients present, on average, five years later than male with complications requiring surgery. Overall, men have a higher incidence of bleeding (P=0.015), whereas women present more often with stricture and obstruction (P=0.02). Young males present more with fistula (P=0.03), whereas older males present with bleeding (P=0.001). Young females present with perforation (P=0.002), and older females present with chronic diverticulitis (P=0.04) and stricture (P=0.04).