The comparative study between right and left sided colonic diverticulitis -retrospective cohort study

抄録

[Background] This study assessed the characteristics of right-sided colonic diverticulitis (RCD) and the optimal management of complicated RCD. [Methods] The present study enrolled 137 consecutive patients with colonic diverticulitis who were admitted to our institution over a 7-year period. The characteristics and treatment methods were compared between RCD and left-sided diverticulitis (LCD). Additionally, the difference between complicated RCD and LCD was investigated. [Results] The RCD patients were younger than the LCD patients (45.6±16.3 years vs. 61.2±16.7 years: P<0.001). The rate of complicated RCD was lower than that of LCD (15.3% vs. 50%: P<0.001）. In the subgroup analysis of patients with complicated colonic diverticulitis, such as those with modified Hinchey stage Ib, the size of the abscess did not differ between the RCD and LCD groups. Eleven of 13 cases with LCD (84.6%) required surgery. On the other hand, no patients with complicated RCD required surgery. One of 13 cases (7.7%) with complicated RCD developed recurrence with modified Hinchey stage Ia after discharge. [Conclusions] Conservative management may be effective for patients with complicated RCD, such as modified Hinchey Stage Ib, irrespective of the size of the abscess and degree of the inflammatory reaction.