W1481: Early Elective Total Colonoscopy in Complicated Sigmoid Diverticulitis: A Prospective Study

Kratt, Thomas; Stüker, D; Meile, Tobias; Küper, Markus A.; Zdichavsky, Marty; Kirschniak, Andreas; Miller, Stephan; Fend, Falko; Königsrainer, Alfred

doi:10.1016/j.gie.2010.03.893

Cited by 4 publications

(15 citation statements)

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“…This risk is higher than that in the normal asymptomatic population, 23,24 in whom the incidence of CRC usually varies between 0.5 and 1 per cent. In previously published studies in patients undergoing colonoscopy as a follow-up after acute diverticulitis, the incidence of advanced adenomas varies between 1 and 18 per cent and CRC between 0 and 3 per cent [12][13][14][15][16][17][18]25 (Table 3). This is in line with our findings.…”

Section: Discussionmentioning

confidence: 99%

“…More recent evidence demonstrates contradictory results, leading some to believe that routine colonoscopy after acute diverticulitis is sometimes not necessary. [11][12][13][14][15][16][17][18] Nowadays, most initial episodes of acute diverticulitis are diagnosed based on a clinical scenario and imaging with high-resolution CT scans. 19 The aim of our study was to evaluate the yield of significant findings on colonoscopy as a follow-up after an episode of acute diverticulitis.…”

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confidence: 99%

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Findings on Colonoscopy after Diverticulitis: A Multicenter Review

Studniarek

Kochar

Warner

et al. 2019

The American Surgeon™

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Diverticular disease is a common problem where patients with diverticulosis have a 1–4 per cent risk of acute diverticulitis. Current guidelines recommend a colonoscopy after.the resolution of acute diverticulitis. The aim of this study was to evaluate the yield of significant findings on colonoscopy after an episode of diverticulitis. This is a retrospective analysis of patients who underwent colonoscopy after an episode of diverticulitis between November 2005 and August 2017 at three major teaching hospitals. Advanced adenomas were defined as adenomas ≥1 cm, serrated adenomas, and tubulovillous or villous adenomas. A total of 584 patients (298 males; 51%) underwent colonoscopy for a history of diverticulitis after resolution of acute symptoms. Colonoscopy was complete in 488 patients (84%). Among these 488 patients, 446 had diverticular disease, 31 had advanced adenomas, and four had adenocarcinomas. Colonoscopies were incomplete in 96 patients (16%). Forty-six of those patients underwent surgery. The overall incidence of advanced adenomas and adenocarcinomas was 32 (5.4%) and nine (1.5%), respectively. In our study, the prevalence of advanced adenomas and adenocarcinomas was relatively high compared with the average risk individuals. Our findings support that patients after an episode of diverticulitis should continue to get a colonoscopy.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Findings on Colonoscopy after Diverticulitis: A Multicenter Review

Studniarek

Kochar

Warner

et al. 2019

The American Surgeon™

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“…6, There were four prospective studies and one retrospective review of a prospective study. 44,60,61,77,89 The remaining studies were retrospective (see Tables S1, S2). Studies were conducted across Europe, North America, Asia, Middle East and Australasia.…”

Section: Study Demographicsmentioning

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%

“…6,25,40,41,44,49,58,63,65,78 Follow up was greater than 80% in 25 studies. 25,29,[31][32][33]39,41,44,45,49,[53][54][55]60,61,63,67,71,74,[77][78][79][80]86,89 Primary study outcomes Colorectal cancers were identified in 2.0% (95% CI 1.67-2.40) of patients undergoing interval colonoscopy or flexible sigmoidoscopy after acute diverticulitis in 68 studies (see Table 1). 6, The distribution of cancers was 27.9% sigmoid/descending colon, 9.0% proximal to splenic flexure, 3.7% in rectum and 59.4% with location not reported.…”

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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Yield of colonoscopy after recent CT-proven uncomplicated acute diverticulitis: a comparative cohort study

et al. 2014

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ACN detection does not differ significantly between patients with recent uncomplicated diverticulitis and average risk screening participants. Routine follow-up colonoscopy after primary CT-proven uncomplicated left-sided acute diverticulitis can be omitted; these patients can participate in CRC screening programs. Follow-up colonoscopy may be beneficial when targeted at high-risk patients, but such an approach first needs prospective evaluation.

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W1481: Early Elective Total Colonoscopy in Complicated Sigmoid Diverticulitis: A Prospective Study

Cited by 4 publications

References 0 publications

Findings on Colonoscopy after Diverticulitis: A Multicenter Review

Findings on Colonoscopy after Diverticulitis: A Multicenter Review

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

Yield of colonoscopy after recent CT-proven uncomplicated acute diverticulitis: a comparative cohort study

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