Abstract | INTRODUCTION: METHODS: Retrospective cohort study of adult patients hospitalized for an initial episode of acute colonic diverticulitis at Memorial Sloan Kettering Cancer Center, 1988-2004. Outcomes in patients receiving systemic chemotherapy within one month of admission for diverticulitis ("Chemo") were compared to outcomes of patients not receiving chemotherapy within the past month ("No-chemo"). RESULTS: A total 131 patients met inclusion criteria. Chemo patients did not differ significantly from No-chemo group in terms of severity of acute diverticulitis at index admission (13.2% vs. 4.4%, respectively, p = 0.12), resumption of chemotherapy (median 2 months), failure of non-operative management (13.2% vs 4.4%, respectively, p = 0.12), frequency of recurrence (20.5% vs 18.5%), hospital length of stay (p = 0.08), and likelihood of interval resection (24.0% vs. 16.2%, respectively, p = 0.39). Chemo patients recurred with more severe disease, were more likely to undergo emergent surgery (75.0% vs. 23.5%, respectively, p = 0.03), and were more likely to be diverted (100.0% vs. 25.0%, respectively, p = 0.03). Chemo patients were significantly more likely to incur a postoperative complication (100% vs 9.1% p < 0.01) following interval resection. Overall mortality was significantly higher in the Chemo vs. No-chemo group. Median survival in Chemo patients was 3.4 years; in No-chemo patients, median survival was not reached at 10 years. CONCLUSION: Our data do not support routine elective surgery for acute diverticulitis in patients receiving chemotherapy. Non-operative management in the acute or interval setting appears preferable whenever possible.
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Authors | Tushar Samdani, Fredric M Pieracci, Soumitra R Eachempati, Jaime Benarroch-Gampel, Alex Weiss, M Cathy Pietanza, Philip S Barie, Garrett M Nash |
Journal | International journal of surgery (London, England)
(Int J Surg)
Vol. 12
Issue 12
Pg. 1489-94
(Dec 2014)
ISSN: 1743-9159 [Electronic] United States |
PMID | 25448673
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved. |
Chemical References |
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Topics |
- Acute Disease
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents
(therapeutic use)
- Cohort Studies
- Colonic Neoplasms
(complications, drug therapy, immunology)
- Diverticulitis, Colonic
(complications, surgery)
- Elective Surgical Procedures
- Female
- Humans
- Immunocompromised Host
- Male
- Middle Aged
- Recurrence
- Retrospective Studies
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