Systematic review and comparison of national and international guidelines on diverticular disease

Galetin, Thomas; Galetin, Amelie; Vestweber, Karl-Heinz; Rink, Andreas D.

doi:10.1007/s00384-017-2960-z

Cited by 79 publications

(64 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, no other significant predictors were found in the multivariable analyses for treatment failure or emergency surgery, making it difficult to select a subpopulation of patients who would benefit from PCD. The findings do seem to acknowledge that a cut‐off value of 3 cm is appropriate for differentiating between small and large abscesses.…”

Section: Discussionmentioning

confidence: 80%

“…Over the years, treatment strategies for diverticulitis with abscess formation have gradually shifted from (emergency) surgical treatment to non‐surgical management comprising antibiotics with or without percutaneous drainage (PCD). Currently, guidelines advise that small pericolic abscesses can be treated with antibiotics, whereas distant (pelvic) or larger abscesses, usually defined as those with a diameter of 3–5 cm or larger, should be treated with PCD, if possible. As patients undergoing non‐surgical treatment are at risk of adverse outcomes such as emergency surgery, disease recurrence, readmission and even death (both in the short and long term), adequate patient selection for the optimal choice of treatment has come to play an important role in the management of these patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Multicentre study of non-surgical management of diverticulitis with abscess formation

Lambrichts

Bolkenstein

Does

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

This multicentre retrospective cohort study included 447 patients with Hinchey Ib and II diverticular abscesses, who were treated with antibiotics, with or without percutaneous drainage. Abscesses of 3 and 5 cm in size were at higher risk of short‐term treatment failure and emergency surgery respectively. Initial non‐surgical treatment of Hinchey Ib and II diverticular abscesses was comparable between patients treated with antibiotics only and those who underwent percutaneous drainage in combination with antibiotics, with regard to short‐ and long‐term outcomes. Most do not need drainage

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Multicentre study of non-surgical management of diverticulitis with abscess formation

Lambrichts

Bolkenstein

Does

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Numerous classifications and modifications describe the various stages of diverticular disease [7,9] widely used classification by Hinchey [10] was intended as an intra-operative stratification of perforated diverticulitis with abscess or peritonitis enabling surgeons to adjust the surgical approach. It was later modified to preoperative use, incorporating CT findings [11].…”

Section: How Is Diverticular Disease Defined and How Should It Be Clamentioning

confidence: 99%

“…There are currently several national guidelines available from member countries of the European Society of Coloproctology (ESCP) on the management of diverticular disease, some of which are not updated [1][2][3][4][5][6][7]. The guidelines committee of the ESCP decided in 2017 to develop a pan-European guideline for the management of diverticular disease, acknowledging that it will be a compromise of different national guidelines and different accessibilities to healthcare and medical procedures in different healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

184

177

View full text Add to dashboard Cite

Aim The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than 90% agreement was considered a consensus. The final phrasing of the statements with < 90% agreement was discussed in a consensus meeting at the ESCP annual meeting in Vienna in September 2019. Thereafter, the first and the last author drafted the final text of the guideline and circulated it for final approval and for a third and final online voting of rephrased statements. Results This guideline contains 38 evidence based consensus statements on the management of diverticular disease. Conclusion This international, multidisciplinary guideline provides an up to date summary of the current knowledge of the management of diverticular disease as a guidance for clinicians and patients.

show abstract

“…Regarding the role of endoscopy in AD or following an attack of acute diverticulitis, Galetin and colleagues [19], in a recent systematic review and comparison of guidelines, confirm that there is discordance in performing colonoscopy in acute diverticulitis. Colonoscopy is usually avoided in patients with suspicion of AD because of the high risk of bowel perforation.…”

Section: Colonoscopy Following Acute Diverticulitismentioning

confidence: 97%

What’s New in Diagnosing Diverticular Disease

Štimac

Nardone²,

Mazzari

et al. 2020

JGLD

View full text Add to dashboard Cite

In this session different issues for the diagnosis of diverticular disease (DD) were considered including “Biomarkers”, “Computer tomography”, “Ultrasonography in detecting acute diverticulitis”, “Endoscopy” and “The DICA classification: a new predictive tool in managing diverticular disease”. Most patients affected by DD suffer from recurrent attacks of abdominal pain without evidence of an active inflammatory process, causing a difficult differential diagnosis with other intestinal conditions. Several biomarkers, serological, fecal, urinary and genetic were considered, but recent studies confirmed that only CRP and fecal calprotectin are matching with the criteria for an ideal biomarker for DD. Colonoscopy still remains the gold standard for the diagnosis of DD, playing a key role in many clinical settings, such as colonic diverticular bleeding, or to differentiate inflammatory bowel disease (IBD) and segmental colitis associated with diverticulosis (SCAD); Moreover, in 2015 has been developed the DICA (Diverticular Inflammation and Complication Assessment) endoscopic classification that considers 10 different parameters, each one with a score, and the sum of items scores represents the severity of the disease; in this way the endoscopic exam would be able to predict the outcome of DD for each patient. On the other hand, computer tomography (CT) is the gold standard for acute diverticulitis (AD) with an excellent sensitivity and specificity; recently, metanalysis of prospective studies have shown that intestinal ultrasonography (IUS) and CT have the same sensitivity for the diagnosis of an AD and the advantage is that IUS is less expensive, non-invasive and easily accessible.

show abstract

Systematic review and comparison of national and international guidelines on diverticular disease

Abstract: There are dissents in the recommendations for central aspects regarding the diagnostic and treatment of diverticular disease in recently published guidelines.

Cited by 79 publications

References 44 publications

Multicentre study of non-surgical management of diverticulitis with abscess formation

Multicentre study of non-surgical management of diverticulitis with abscess formation

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

What’s New in Diagnosing Diverticular Disease

Contact Info

Product

Resources

About