[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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The recent sharp increase in the number of people with diverticular disease, particularly in the Western industrial nations, necessitates the analysis of all epidemiological, pathogenetical, anatomical, and pathophysiological parameters of the disease.A number of mutually realted pathogenetic factors, classified as social, biological, colonic wall and intraluminary, are responsible for the appearance of this disease.Pathophysiology considerably influences the prognosis.Predominant decisive factors in the diagnosis are radiological demonstration (e.g.double-contrast study of the colon) and cilnical symptoms.Subtle X-ray diagnosis also assists in the acquisition of information about the relative frequency and localization of the of the diverticula.Distribution into three clinical stages is based on therapeutical observation. Operating techniques are standardized tody and as is shown in this study, can be applied differentially in Stages II and III.For patients in Stage II, primary resection is the “elected” procedure, while Stage III usually calls for multi-stage resections, the incontinuity resection of the Hartmann type being the preferred method.Because of poor prognosis in cases with complications, resection should be carried out in the early stages of the disease;inflammatory involvement caused by incomplete diverticula also speaks for early resection. Insufficient data are available to evaluate the various myotomy techniques. Colonic fistulas, which appear in about 15% of the cases of diverticular disease, require a multistage operational procedure in the majority of the cases.Combined intraoperative evaluation of the resected segment is advantageous in determing the achieved operative radicalness, especially regarding the pathogenetically important incomplete diverticula. This procedure is also an aid in bringing to light new aspects concerning the genesis and spread of diverticular disease.

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