Highlights
- •This manuscript discusses controversies in diverticulitis, trying to answer the following questions:
- •Who should be doing diverticulitis surgery in the US?
- •Do all Hinchey II patients need elective surgery?
- •Should we give antibiotics for uncomplicated disease?
- •What's the threshold for elective colectomy in uncomplicated disease?
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References
- A son's tribute.Arch Surg. 2005; 140: 1052-1054https://doi.org/10.1001/archsurg.140.11.1052
- You can make a difference.Bull Am Coll Surg. 2003 Dec; 88 (PMID: 23586153): 8-12
- (Address of Thomas Henry Huxley, President, Start Page 400, Quote Page 402, Column 1)1870 September 15, Nature, Section: The British Association – Liverpool Meeting. Macmillan and Company, London1870
- The effect of surgical training and operative approach on outcomes in acute diverticulitis: should guidelines Be revised?.Dis Colon Rectum. 2019 Jan; 62 (PMID: 30451762): 71-78https://doi.org/10.1097/DCR.0000000000001240
- Disparities influencing rates of urgent/emergent surgery for diverticulitis in the state of Florida.Am J Surg. 2020 Jun; 219 (Epub 2019 Sep 10. PMID: 31526510): 1012-1018https://doi.org/10.1016/j.amjsurg.2019.09.005
- Disparities in elective surgery for diverticulitis: identifying the gap in care.Am J Surg. 2019 Nov; 218 (Epub 2019 Mar 5. PMID: 30878216): 899-906https://doi.org/10.1016/j.amjsurg.2019.03.001
- Emergent colon resections: does surgeon specialization influence outcomes?.Dis Colon Rectum. 2019 Jan; 62 (PMID: 30394983): 79-87https://doi.org/10.1097/DCR.0000000000001230
- Subspecialist emergency management of diverticulitis is associated with reduced mortality and fewer stomas.Colorectal Dis. 2013 Apr; 15: 442-447https://doi.org/10.1111/codi.12022.PMID:22966859
- How much colorectal surgery do general surgeons do?.in: J Am Coll Surg. vol. 194. PMID, 2002: 37-39https://doi.org/10.1016/s1072-7515(01)01116-4
- Laparoscopic colectomy and the general surgeon.J Gastrointest Surg. 2016 Mar; 20 (Epub 2015 Sep 18. PMID: 26385005): 640-643https://doi.org/10.1007/s11605-015-2943-8
- Practice parameters for the treatment of sigmoid diverticulitis.Dis Colon Rectum. 2014 Mar; 57 (PMID: 24509449): 284-294https://doi.org/10.1097/DCR.0000000000000075
- Is laparoscopic surgery applicable to complicated colonic diverticular disease?.Surg Endosc. 1997 Oct; 11: 1021-1025https://doi.org/10.1007/s004649900516.PMID:9381341
- Elective resection versus observation after nonoperative management of complicated diverticulitis with abscess: a systematic review and meta-analysis.Dis Colon Rectum. 2014 Dec; 57 (PMID: 25380010): 1430-1440https://doi.org/10.1097/DCR.0000000000000230
- Diverticulitis recurrence after percutaneous abscess drainage.Int J Colorectal Dis. 2017 Oct; 32 (Epub 2017 May 30. PMID: 28555444): 1367-1373https://doi.org/10.1007/s00384-017-2825-5
- Randomized clinical trial of elective resection versus observation in diverticulitis with extraluminal air or abscess initially managed conservatively.Br J Surg. 2018 Jul; 105 (Epub 2018 Apr 23. PMID: 29683483): 971-979https://doi.org/10.1002/bjs.10868
- Recurrence and virulence of colonic diverticulitis in immunocompromised patients.Am J Surg. 2012 Aug; 204 (Epub 2012 Mar 23. PMID: 22444713): 172-179https://doi.org/10.1016/j.amjsurg.2011.09.027
- Diverticulitis in transplant patients and patients on chronic corticosteroid therapy: a systematic review.Dis Colon Rectum. 2010 Dec; 53 (PMID: 21178867): 1699-1707https://doi.org/10.1007/DCR.0b013e3181f5643c
- Sigmoid colectomy for acute diverticulitis in immunosuppressed vs immunocompetent patients: outcomes from the ACS-NSQIP database.Dis Colon Rectum. 2016 Feb; 59 (PMID: 26734967): 101-109https://doi.org/10.1097/DCR.0000000000000513
- Prepared on behalf of the clinical practice guidelines committee of the American society of colon and rectal surgeons. The American society of colon and rectal surgeons clinical practice guidelines for the treatment of left-sided colonic diverticulitis.Dis Colon Rectum. 2020 Jun; 63 (PMID: 32384404): 728-747https://doi.org/10.1097/DCR.0000000000001679
- Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis.Br J Surg. 2012 Apr; 99 (Epub 2012 Jan 30. PMID: 22290281): 532-539https://doi.org/10.1002/bjs.8688
- Dutch Diverticular Disease (3D) Collaborative Study Group. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis.Br J Surg. 2017 Jan; 104 (Epub 2016 Sep 30. PMID: 27686365): 52-61https://doi.org/10.1002/bjs.10309
- Dutch diverticular disease (3D) collaborative study group. Long-term effects of omitting antibiotics in uncomplicated acute diverticulitis.Am J Gastroenterol. 2018 Jul; 113 (Epub 2018 May 11. PMID: 29700480): 1045-1052https://doi.org/10.1038/s41395-018-0030-y
- Efficacy and safety of nonantibiotic outpatient treatment in mild acute diverticulitis (DINAMO-study): a multicentre, randomised, open-label, noninferiority trial.Ann Surg. 2021 Nov 1; 274 (PMID: 34183510): e435-e442https://doi.org/10.1097/SLA.0000000000005031
- Management of acute uncomplicated diverticulitis without antibiotics: a systematic review, meta-analysis, and meta-regression of predictors of treatment failure.Tech Coloproctol. 2018 Jul; 22 (Epub 2018 Jul 6. PMID: 29980885): 499-509https://doi.org/10.1007/s10151-018-1817-y
- Meta-analyses of current strategies to treat uncomplicated diverticulitis.Dis Colon Rectum. 2019 Mar; 62 (PMID: 30570549): 371-378https://doi.org/10.1097/DCR.0000000000001295
- Long-term follow-up after an initial episode of diverticulitis: what are the predictors of recurrence?.Dis Colon Rectum. 2011 Mar; 54 (PMID: 21304297): 283-288https://doi.org/10.1007/DCR.0b013e3182028576
- Patterns of recurrence in patients with acute diverticulitis.Br J Surg. 2010 Jun; 97: 952-957https://doi.org/10.1002/bjs.7035.PMID:20474006
- Dutch diverticular disease (3D) collaborative study group. Quality of life and persistent symptoms after uncomplicated acute diverticulitis.Dis Colon Rectum. 2019 May; 62 (PMID: 30807455): 608-614https://doi.org/10.1097/DCR.0000000000001361
- Elective laparoscopic sigmoid colectomy for diverticulitis-an updated look at recurrence after surgery.J Gastrointest Surg. 2020 Feb; 24 (Epub 2019 Jan 22. PMID: 30671801): 388-395https://doi.org/10.1007/s11605-018-04083-y
- Elective surgery for diverticulitis and the risk of recurrence and ostomy.in: Ann Surg. vol. 273. PMCID, 2021 Jun 1: 1157-1164https://doi.org/10.1097/SLA.0000000000003639 (PMID: 31651534)
- Dutch diverticular disease (3D) collaborative study group. Long-Term outcome of surgery versus conservative management for recurrent and ongoing complaints after an episode of diverticulitis: 5-year follow-up results of a multicenter randomized controlled trial (DIRECT-Trial).Ann Surg. 2019 Apr; 269 (PMID: 30247329): 612-620https://doi.org/10.1097/SLA.0000000000003033
- Surgical evolution and evidence-based medicine.General Surgery Audio Digest. 2008; 55
- Sabiston Textbook of Surgery.seventeenth ed. Saunders, 2004
Article info
Publication history
Published online: September 13, 2022
Accepted:
September 8,
2022
Received:
July 12,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
