Die Kolondivertikelkrankheit - neue Aspekte und Ergebnisse aktueller operativer Strategie in der Behandlung der Divertikulitis
The diverticulitis of the colon is primarily a disease of the western civilization. There are different types of diverticula rarely recognized in the clinical workaround. E.g. the diverticulitis of the right bowel is completely different to that of the left bowel concerning aetiology and treatment. In this work not only the typical questions about modern operative strategy are answered but the disease is also completely reflected in all aspects concerning aetiology, types, conservative treatment, recognition in history of medicine, differential diagnosis and clinical assessment and evaluation. In the past years the one stage operation is more performed shown to be safe also in purulent diverticulitis. But in clinical routine even today this is not established everywhere dependant from the experience of the surgeon and lacking implementation of scientific results. The primary anastomosis is safe even in purulent disease if the patient is not multimorbide. There is lacking system of a validated staging to compare the results of operations, and the author proposed a new classification. More operation in acute diverticulitis can be done laparoscopicly or laparoscopic assisted. There are patients who have asymptomatic diverticula but have irritable bowel syndrome. The GLQI (gastrointestinal life quality index) is a good but not perfect instrument to evaluate operative treatment success. If a diverticulitis is safely diagnosed an operation should be done after the second episode or attack because of the mechanic irreversible alteration of the bowel wall. In former times many operation were too late and often at last after life-threatening complications. In practice it is often not differentiated between acute and chronic diverticulitis and there are lacking data concerning the course of the disease. Genetic aetiology is badly studied and investigated. This abstract cannot be complete because this dissertation has an approach of postdoctoral lecture qualification.
Subject HeadingsDivertikulitis [GND]
Anastomosis, surgical [MeSH]
Colon; Surgery [MeSH]
Irritable bowle syndrome [MeSH]