Interval colonoscopy following acute diverticulitis should not be discouraged yet: results from a retrospective cohort

Santacruz, Carlos Cerdán; Álvarez, P. Muriel; Ferreruela, Gonzalo Roig; Resina, Mireia Merichal; Somalo, Ana Isabel Pinillos; Petit, Núria Mestres; Grañón, José Enrique Sierra; Kissler, Jorge Juan Olsina

doi:10.1007/s00464-020-08187-y

Cited by 6 publications

(9 citation statements)

References 36 publications

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“…Median age was 58 years (mean 56) and male to female ratio was 0.84. Median timing of interval scopes was 10.5 weeks (mean 11.8, range 0.9–32 weeks) and was reported in 12 studies 25,30,35,49,50,59,60,62,63,78,85,89 …”

Section: Resultsmentioning

confidence: 91%

“…A total of 68 studies with 13 905 patients were included 6,24–90 . There were four prospective studies and one retrospective review of a prospective study 44,60,61,77,89 .…”

Section: Resultsmentioning

confidence: 99%

“…There were 13 296 patients from 65 studies who underwent a follow up colonoscopy 6,24–42,44–65,67–79,81–90 . The remaining three studies (231 patients) reported follow up with either a colonoscopy or flexible sigmoidoscopy and did not differentiate between the two 43,66,80 .…”

Section: Resultsmentioning

confidence: 99%

“…Median timing of interval scopes was 10.5 weeks (mean 11.8, range 0.9-32 weeks) and was reported in 12 studies. 25,30,35,49,50,59,60,62,63,78,85,89 There were 13 296 patients from 65 studies who underwent a follow up colonoscopy. 6,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][67][68][69][70][71][72][73][74][75][76][77][78][79][81][82][83][84][85][86]…”

Section: Study Demographicsmentioning

confidence: 99%

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Endoscopic findings after CT proven acute diverticulitis: a systematic review and meta‐analysis

Cao

Lam

Rickard

2022

ANZ Journal of Surgery

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Background Traditionally, international guidelines recommend patients with acute diverticulitis should be followed up with a colonoscopy 6–8 weeks after discharge. However, the need for an interval colonoscopy has been increasingly challenged in the setting of computed tomography (CT). Previous meta‐analyses have included studies which combined suspected rather than imaging confirmed diverticulitis and often without correlation with endoscopic findings. This meta‐analysis aims to investigate endoscopic findings of patients with CT confirmed diverticulitis. Methods An electronic search of Medline, PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus, Clinicaltrials.gov and WHO ICTRP was performed up to October 18, 2021. Studies which reported CT confirmed acute diverticulitis in adults and who underwent endoscopic follow‐up with either a colonoscopy or flexible sigmoidoscopy were included. Studies were excluded if diverticulitis was diagnosed by clinical grounds alone, ultrasound, barium enema, or other non‐CT forms of imaging. Results A total of 68 studies with 13 905 patients were included. Median age was 58 years and male to female ratio was 0.84. Cancer was detected in 2.0% and advanced adenoma in 3.8%. Complicated diverticulitis had 9.2 higher odds of cancer compared to uncomplicated diverticulitis (95% CI 4.42–19.08, P < 0.001). Adenomas were detected in 17%. Of those diagnosed with colorectal cancer, 85% were concordant with the site of the diverticulitis on CT while 15% were incidental findings. Conclusion Routine colonoscopic follow up should be recommended in medically fit patients who have CT proven acute diverticulitis due to the higher than population prevalence of colorectal cancer and advanced adenomas.

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Section: Resultsmentioning

confidence: 91%

“…A total of 68 studies with 13 905 patients were included 6,24–90 . There were four prospective studies and one retrospective review of a prospective study 44,60,61,77,89 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Demographicsmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic findings after CT proven acute diverticulitis: a systematic review and meta‐analysis

Cao

Lam

Rickard

2022

ANZ Journal of Surgery

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“…[8] Differentiation between acute uncomplicated and complicated diverticulitis seems debatable concerning the need for a routine colonoscopy. [9][10][11][12][13][14] Most industrialized countries have implemented screening programs for the early detection of CRC. Furthermore, it is established that screening colonoscopy (SC) is cost-effective and preventive.…”

Section: Introductionmentioning

confidence: 99%

To Scope or not to Scope; Value of Routine Colonoscopy after Uncomplicated Diverticulitis in Switzerland. A Retrospective Cohort Study

Hess

Gnägi

Seppey

et al. 2022

Preprint

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Purpose Diverticular disease is common in the western world. Due to the risk of undetected underlying colorectal cancer, most guidelines recommend a follow-up colonoscopy after an episode of diverticulitis. With the increased accuracy of computer tomography scans, there is an increased challenge to these guidelines in cases of uncomplicated diverticulitis. The aim of this study was to investigate the compliance to the recommended follow-up colonoscopies and to report the incidence of detection of advanced neoplasms. Methods In this single-center retrospective cohort study, all patients > 18 years that were admitted to the Hospital Center Biel with an episode of acute uncomplicated diverticulitis between 01.01.2013 and 31.12.2017 were identified. The incidence of advanced neoplasia was calculated by analyzing the follow-up colonoscopies performed and reviewing the histological findings. Results 257 Patients with uncomplicated diverticulitis were included in this study. The mean age of the patients was 63 (range 22–96) years, and 54.5% were female. In 197 (77%) patients we recommended a follow-up colonoscopy. However, only 144 (73%) of these patients underwent the procedure. In the histological analysis, 2 (1.2%) carcinomas, one high-grade adenoma (0.6%) and 20 low-grade adenomas (12%) were detected. Conclusion The compliance to the recommendation of follow-up colonoscopies after uncomplicated diverticulitis is poor and has to be improved. A follow-up colonoscopy has its justification because of relevant findings in almost 14% of patients, more so in patients above screening age with 20% pathological findings, including 2 (5%) carcinomas.

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Colonoscopy follow-up for acute diverticulitis: a multi-centre review

et al. 2022

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Interval colonoscopy following acute diverticulitis should not be discouraged yet: results from a retrospective cohort

Cited by 6 publications

References 36 publications

Endoscopic findings after CT proven acute diverticulitis: a systematic review and meta‐analysis

Endoscopic findings after CT proven acute diverticulitis: a systematic review and meta‐analysis

To Scope or not to Scope; Value of Routine Colonoscopy after Uncomplicated Diverticulitis in Switzerland. A Retrospective Cohort Study

Colonoscopy follow-up for acute diverticulitis: a multi-centre review

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