Predictors of postoperative outcomes for patients with diverticular abscess initially treated with percutaneous drainage

Elagili, Faisal and Luca, Stocchi and Ozuner, Gokhan and Mody, Rekha and Baker, Mark E and Kiran, Ravi P (2015) Predictors of postoperative outcomes for patients with diverticular abscess initially treated with percutaneous drainage. The American Journal of Surgery, 209 (4). pp. 703-708. ISSN 0002-9610

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Abstract

BACKGROUND: The aim of our study was to evaluate factors associated with percutaneous drainage (PCD) failure, complications, and stoma creation for patients undergoing sigmoidectomy for diverticular abscess. METHODS: Data for patients with diverticular abscess greater than or equal to 3 cm in diameter treated with initial PCD from 1994 to 2012 were identified. RESULTS: One hundred fourteen patients (54% male) with a mean age of 57 years and a mean abscess diameter of 7.1 6 2.4 cm were identified. American Society of Anesthesiologists 4 was the only independent factor associated with PCD failure (P , .001). On multivariate analysis, factors associated with postoperative morbidity (n 5 42, 37%) included PCD failure (P 5 .02) and older age (P 5 .04), while risk for stoma creation was associated with PCD failure (P , .001), multiple PCD attempts (P 5 .002), older age (P , .001), Hinchey II (P 5 .03), and increased body mass index (P 5 .01). American Society of Anesthesiologists 4 was the only factor associated with permanent stoma (P 5 .02). CONCLUSIONS: In patients with large diverticular abscess, a successful PCD is associated with reduced postoperative morbidity. However, a large proportion of patients require stoma creation. Significant comorbidity is associated with both failure of PCD and permanent stoma risk.

Item Type:	Article (Journal)
Additional Information:	8115/69698
Uncontrolled Keywords:	Sigmoid diverticulitis; Diverticular abscess; Percutaneous drainage; Postoperative outcomes
Subjects:	R Medicine > RD Surgery
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine
Depositing User:	Asst Prof Faisal Elagili
Date Deposited:	03 Apr 2019 09:48
Last Modified:	03 Apr 2019 09:49
URI:	http://irep.iium.edu.my/id/eprint/69698

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