Diverticulitis is a common condition where inflammation seems to play a key role in all forms of the disease. Since diverticular disease, in some cases, exhibits clinical and histopathologic similarities with the idiopathic inflammatory bowel disease, could have in common, with these some environmental risk factors, as appendectomy, that could interfere with the natural history of diverticular disease. Since the prevalence and the role of appendectomy in patients with colonic diverticula has not been defined, the aim of this study was to evaluate the prevalence of appendectomy, both in uncomplicated diverticular disease and in patients with diverticulitis. Two hundred and seven consecutive patients with verified diagnosis of diverticular disease of the colon were enrolled. Diagnosis of diverticulitis was defined by means of clinical, colonoscopic, and computerised tomography criteria. Logistic regression was used to describe the relation between the dependent variable (diverticulitis) and several covariates: sex, age (<>60), BMI (<>26), and history of appendectomy (emergency or elective appendectomy). We included the first order interactions in the model to assess the effect of each variable for a particular degree of the others covariates. Statistical analysis was performed using SPSS software. Results: The first order interactions did not show a relevant effect (p>0.10) and therefore were excluded from the logistic model. Sex (p=0.88), BMI (p=0.80), elective appendectomy (p=0.17), age (p=0,11), do not affect significantly, either as an independent variable or as a confounder, the risk of development of diverticulitis, and therefore were also excluded from the model. According to the final model the risk of diverticulitis is 4,94 fold higher (95% confidence interval: 1.98 to 12.37) in patients with history of appendectomy with emergency operative treatment, compared with patients without appendectomy or history of elective resection (p<0.001. Conclusions: The risk of diverticulitis does not increase in patients with elective appendectomy, therefore only patients with emergency appendectomy have an increased risk of diverticulitis
Effect of Appendectomy on ClinicalCourse of Diverticulosis / P., Usai; I., Ibba; Ma, Lai; Mf, Boi; Cuomo, Rosario; Mf, Savarese; P., Contu; G., Diaz; S., Gemini; G., D'Alia. - In: GASTROENTEROLOGY. - ISSN 0016-5085. - ELETTRONICO. - Volume 138, Issue 5, Supplement 1:(2010), pp. S365-S365. [10.1016/S0016-5085(10)61684-8]
Effect of Appendectomy on ClinicalCourse of Diverticulosis
CUOMO, ROSARIO;
2010
Abstract
Diverticulitis is a common condition where inflammation seems to play a key role in all forms of the disease. Since diverticular disease, in some cases, exhibits clinical and histopathologic similarities with the idiopathic inflammatory bowel disease, could have in common, with these some environmental risk factors, as appendectomy, that could interfere with the natural history of diverticular disease. Since the prevalence and the role of appendectomy in patients with colonic diverticula has not been defined, the aim of this study was to evaluate the prevalence of appendectomy, both in uncomplicated diverticular disease and in patients with diverticulitis. Two hundred and seven consecutive patients with verified diagnosis of diverticular disease of the colon were enrolled. Diagnosis of diverticulitis was defined by means of clinical, colonoscopic, and computerised tomography criteria. Logistic regression was used to describe the relation between the dependent variable (diverticulitis) and several covariates: sex, age (<>60), BMI (<>26), and history of appendectomy (emergency or elective appendectomy). We included the first order interactions in the model to assess the effect of each variable for a particular degree of the others covariates. Statistical analysis was performed using SPSS software. Results: The first order interactions did not show a relevant effect (p>0.10) and therefore were excluded from the logistic model. Sex (p=0.88), BMI (p=0.80), elective appendectomy (p=0.17), age (p=0,11), do not affect significantly, either as an independent variable or as a confounder, the risk of development of diverticulitis, and therefore were also excluded from the model. According to the final model the risk of diverticulitis is 4,94 fold higher (95% confidence interval: 1.98 to 12.37) in patients with history of appendectomy with emergency operative treatment, compared with patients without appendectomy or history of elective resection (p<0.001. Conclusions: The risk of diverticulitis does not increase in patients with elective appendectomy, therefore only patients with emergency appendectomy have an increased risk of diverticulitisFile | Dimensione | Formato | |
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