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https://www.readbyqxmd.com/read/28054168/minimally-invasive-surgery-for-complicated-diverticulitis
#1
Najjia N Mahmoud, Elijah W Riddle
Recent guidelines recommend an individualized approach to recurrent uncomplicated diverticulitis, reflecting research showing that non-operative treatment is safe. Thus, the majority of operations for diverticulitis in the future may be for complicated indications. A laparoscopic approach may be used for both acute and chronic complicated diverticulitis in appropriate patients, as described in the American and European guidelines. However, a safe approach to minimally invasive surgery requires recognition when conditions deteriorate or are not suited to laparoscopy as well as knowledge of a variety of technical maneuvers that elucidate difficult anatomy and facilitate resection...
January 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28035461/is-early-colonoscopy-after-ct-diagnosed-diverticulitis-still-necessary
#2
Thomas Surya Suhardja, Shana Norhadi, Edward Zhenyu Seah, Stephen Rodgers-Wilson
PURPOSE: WHO GLOBOCAN 2012 data showed that Australia and New Zealand have the highest incidence rates of colorectal cancer in the world (Ferlay et al. 1). Current guidelines recommend that patients admitted for an episode of acute diverticulitis require an early follow-up colonoscopy to rule out colorectal malignancy as reported by Fozard et al. (Colorectal Dis 13:1-11, 2011). Recent studies however have indicated that this may not be warranted (Brar et al. Dis Colon rectum 56:1259-1264, 2013)...
December 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27973463/rationale-and-evidences-for-treatment-of-symptomatic-uncomplicated-diverticular-disease
#3
Rosario Cuomo, Martina Cargiolli, Paolo Andreozzi, Francesco P Zito, Giovanni Sarnelli
INTRODUCTION: Symptomatic uncomplicated diverticular disease (SUDD) is one of the possible clinical manifestations of diverticular disease. It is a common disorder characterized by chronic abdominal symptoms ranging from lower left abdominal pain to alteration of bowel habit, that significantly reduce quality of life of subject affected. The present article aims to review the current data for medical management of SUDD. EVIDENCE ACQUISITION: We analyzed the existing literature on the factors involved in the pathogenesis of SUDD and we highlighted the possible target for treatment...
December 14, 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27941344/routine-colonoscopy-after-acute-uncomplicated-diverticulitis-challenging-a-putative-indication
#4
Patrícia Andrade, Armando Ribeiro, Rosa Ramalho, Susana Lopes, Guilherme Macedo
BACKGROUND AND AIMS: Most international guidelines recommend performing a routine colonoscopy after the conservative management of acute diverticulitis, mainly to rule out a colorectal malignancy; however, data to support these recommendations are scarce and conflicting. This study is aimed at determining the rate of advanced colonic neoplasia (ACN) found by colonoscopy, and hence the need for routine colonoscopy after CT-diagnosed acute diverticulitis. METHODS: We retrospectively analyzed all patients hospitalized for acute diverticulitis between July 2008 and June 2013...
December 10, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27830672/an-approach-to-complicated-diverticular-disease-a-retrospective-study-in-an-acute-care-surgery-service-recently-established
#5
Savino Occhionorelli, Monica Zese, Daniela Tartarini, Domenica Lacavalla, Stefano Maccatrozzo, Giacomo Groppo, Maria Grazia Sibilla, Rocco Stano, Lorenzo Cappellari, Giorgio Vasquez
AIM: Acute diverticulitis is a frequent disease in the Western Countries. The increase number of patients admitted in the Surgery Departments led the necessity of new Scores and Classifications in order to clarify, in absence of clear guidelines, the best treatments to offer in the different situations. METHODS: A retrospective study of ninety-nine patients treated in our Department from June 2010 and March 2015. RESULTS: In our study 41 patients were treated conservatively, the remaining 58 were operated, 56 laparotomic and 2 laparoscopic...
October 10, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27686365/randomized-clinical-trial-of-observational-versus-antibiotic-treatment-for-a-first-episode-of-ct-proven-uncomplicated-acute-diverticulitis
#6
L Daniels, Ç Ünlü, N de Korte, S van Dieren, H B Stockmann, B C Vrouenraets, E C Consten, J A van der Hoeven, Q A Eijsbouts, I F Faneyte, W A Bemelman, M G Dijkgraaf, M A Boermeester
BACKGROUND: Antibiotics are advised in most guidelines on acute diverticulitis, despite a lack of evidence to support their routine use. This trial compared the effectiveness of a strategy with or without antibiotics for a first episode of uncomplicated acute diverticulitis. METHODS: Patients with CT-proven, primary, left-sided, uncomplicated, acute diverticulitis were included at 22 clinical sites in the Netherlands, and assigned randomly to an observational or antibiotic treatment strategy...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/27622377/the-management-of-patients-with-diverticulosis-and-diverticular-disease-in-primary-care-an-online-survey-among-italian-general-pratictioners
#7
Rudi De Bastiani, Guido Sanna, Pierluigi Fracasso, Maurizio D'Urso, Edoardo Benedetto, Antonio Tursi
GOALS: To investigate the current opinion of Italian general practitioners (GPs) on the management of patients with diverticular disease (DD) of the colon. BACKGROUND: The management of DD remains a point of debate, and guidelines are not uniform in their advice. STUDY: A web-based survey was conducted among Italian GPs. Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. RESULTS: In total, 245 surveys were filled out...
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27622374/when-should-we-operate-for-recurrent-diverticulitis
#8
Savvas Papagrigoriadis
Recent guidelines on elective surgery for recurrent diverticulitis have removed generalized recommendations for elective preventive surgery and advice individualized decision per patient. We discuss the clinical evidence and potential use of risk factors to help with decision-making for patient selection for elective surgery in the presence of a history of diverticulitis.
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27622371/probiotics-for-the-treatment-of-symptomatic-uncomplicated-diverticular-disease-rationale-and-current-evidence
#9
Carmelo Scarpignato, Anna Bertelé, Antonio Tursi
Changes in the colonic microbiota are critical to the pathogenesis of diverticular complications such as diverticulitis and peridiverticular abscesses. However, more subtle changes in microbiota composition may well be important to the more chronic manifestations of diverticulosis. Some studies have shown the presence of bacterial overgrowth in subgroups of patients with diverticular disease and recent studies, using molecular biology techniques, found an increase of proteobacteria and actinobacteria in patients with symptomatic uncomplicated diverticular disease (SUDD), compared with healthy controls...
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27622366/united-states-guidelines-for-diverticulitis-treatment
#10
Martin H Floch, Walter E Longo
Guidelines for diverticular disease management were last supported and published by the American Gastroenterology Association and the American College of Gastroenterology 2 decades ago. Guidelines have been published in other countries and by some societies. These guidelines are suggested as United States of America guidelines. In reality, they are what is practiced in Connecticut at Yale New Haven hospitals. The epidemiology and pathophysiology is described. This is still considered a dietary fiber-deficiency disease that results in high intracolonic pressure with resultant outpocketing of diverticula in the weakest point of the colon at the sites of vascular penetration with developing elastin deposition in the colon wall...
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27622365/management-of-diverticular-disease-in-scandinavia
#11
Johannes K Schultz, Sheraz Yaqub, Tom Øresland
Throughout the last century, the incidence of diverticular disease of the colon has increased tremendously in industrialized countries; nevertheless, the management of this condition is still controversial. Although several international guidelines for the management of diverticular disease are based on the same evidence, the recommendations differ greatly, emphasizing the lack of high-quality prospective studies. In Scandinavia, official guidelines for the management of diverticular disease exist only in Denmark...
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27622363/italian-guidelines
#12
Bruno Annibale, Marilia Carabotti, Rosario Cuomo
Diverticular disease (DD) is a widespread condition, however limited evidences are available about its management and complications. In the last years, an Italian Consensus Conference promoted by GRIMAD (Gruppo Italiano Malattia Diverticolare, Italian Group on Diverticular Diseases) and a Guideline, by Italian Society of Colorectal Surgery (SICCR) were published. The aim of the Consensus was to provide clinical recommendation for appropriate definition, diagnosis, and management of DD, in particular 4 areas of interest were identified, namely: (i) definition and epidemiology, (ii) pathophysiology, (iii) diagnosis, and (iv) medical and surgical treatment...
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27622354/intestinal-ultrasonography-in-the-diagnosis-and-management-of-colonic-diverticular-disease
#13
Giovanni Maconi, Stefania Carmagnola, Tom Guzowski
Diverticula of the colon and their symptomatic manifestations, including acute diverticulitis (AD), are frequent complaints and the cause of an increasing burden of ambulatory visits, diagnostic procedures, and hospital admissions. Endoscopic and radiologic diagnostic procedures have a well-known role in the diagnosis and management of the disease, but recently intestinal ultrasonography has been proposed as a complementary tool in the diagnosis and follow-up of diverticular disease. This review shows the main sonographic features of diverticula and discusses the potential role of ultrasound in suggesting the presence of symptomatic uncomplicated diverticular disease of the colon...
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27611011/an-unrestricted-diet-for-uncomplicated-diverticulitis-is-safe-results-of-the-prospective-diverticulitis-diet-study
#14
M A W Stam, W A Draaisma, B J M van de Wall, H E Bolkenstein, E C J Consten, I A M J Broeders
AIM: The optimal diet for uncomplicated diverticulitis is unclear. Guidelines refrain from recommendation due to lack of objective information. The aim of the study was to determine whether an unrestricted diet during a first acute episode of uncomplicated diverticulitis is safe. METHOD: A prospective cohort study was performed of patients diagnosed with diverticulitis for the first time between 2012 and 2014. Requirements for inclusion were radiologically proven modified Hinchey 1a/b diverticulitis, ASA I-III and the ability to tolerate an unrestricted diet...
September 9, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27572068/current-status-of-laparoscopy-for-acute-abdomen-in-italy-a-critical-appraisal-of-2012-clinical-guidelines-from-two-consecutive-nationwide-surveys-with-analysis-of-271-323-cases-over-5%C3%A2-years
#15
Ferdinando Agresta, Fabio Cesare Campanile, Mauro Podda, Nicola Cillara, Graziano Pernazza, Valentina Giaccaglia, Luigi Ciccoritti, Giovanna Ioia, Stefano Mandalà, Camillo La Barbera, Arianna Birindelli, Massimo Sartelli, Salomone Di Saverio
BACKGROUND: Several authors have demonstrated the safety and feasibility of laparoscopy in selected cases of abdominal emergencies. The aim of the study was to analyse the current Italian practice on the use of laparoscopy in abdominal emergencies and to evaluate the impact of the 2012 national guidelines on the daily surgical activity. METHODS: Two surveys (42 closed-ended questions) on the use of laparoscopy in acute abdomen were conducted nationwide with an online questionnaire, respectively, before (2010) and after (2014) the national guidelines publication...
August 29, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27494997/changing-paradigms-in-the-management-of-diverticulitis
#16
REVIEW
Nir Horesh, Nir Wasserberg, Andrew P Zbar, Aviad Gravetz, Yaniv Berger, Mordechai Gutman, Danny Rosin, Oded Zmora
The management of diverticular disease has evolved in the last few decades from a structured therapeutic approach including operative management in almost all cases to a variety of medical and surgical approaches leading to a more individualized strategy. There is an ongoing debate among surgeons about the surgical management of diverticular disease, questioning not only the surgical procedure of choice, but also about who should be operated and the timing of surgery, both in complicated and uncomplicated diverticular disease...
September 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27478494/wses-guidelines-for-the-management-of-acute-left-sided-colonic-diverticulitis-in-the-emergency-setting
#17
REVIEW
Massimo Sartelli, Fausto Catena, Luca Ansaloni, Federico Coccolini, Ewen A Griffiths, Fikri M Abu-Zidan, Salomone Di Saverio, Jan Ulrych, Yoram Kluger, Ofir Ben-Ishay, Frederick A Moore, Rao R Ivatury, Raul Coimbra, Andrew B Peitzman, Ari Leppaniemi, Gustavo P Fraga, Ronald V Maier, Osvaldo Chiara, Jeffry Kashuk, Boris Sakakushev, Dieter G Weber, Rifat Latifi, Walter Biffl, Miklosh Bala, Aleksandar Karamarkovic, Kenji Inaba, Carlos A Ordonez, Andreas Hecker, Goran Augustin, Zaza Demetrashvili, Renato Bessa Melo, Sanjay Marwah, Sanoop K Zachariah, Vishal G Shelat, Michael McFarlane, Miran Rems, Carlos Augusto Gomes, Mario Paulo Faro, Gerson Alves Pereira Júnior, Ionut Negoi, Yunfeng Cui, Norio Sato, Andras Vereczkei, Giovanni Bellanova, Arianna Birindelli, Isidoro Di Carlo, Kenneth Y Kok, Mahir Gachabayov, Georgios Gkiokas, Konstantinos Bouliaris, Elif Çolak, Arda Isik, Daniel Rios-Cruz, Rodolfo Soto, Ernest E Moore
Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference...
2016: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/27259547/-sigmoid-colon-diverticulitis-treatment-modalities-2011-2013
#18
A A Schnitzbauer, D Pieper, E A M Neugebauer, W O Bechstein
INTRODUCTION: Diverticulosis is a relevant disease in Germany with a prevalence of over 60 % in patients aged ≥70 years. The S2k guidelines for the treatment of diverticulosis were recently published. Systematic epidemiological data on treatment modalities do not exist. METHODS: Analysis of in-hospital treatment modalities for diverticulosis based on data from the Federal Office of Statistics. RESULTS: Approximately 130,000 inpatient cases of diverticulosis are treated in Germany per year...
August 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27029799/short-term-mortality-readmission-and-recurrence-in-treatment-of-acute-diverticulitis-with-abscess-formation-a-nationwide-register-based-cohort-study
#19
Rasmus Gregersen, Kristoffer Andresen, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
PURPOSE: The aim of the study was to investigate short-term mortality, readmission, and recurrence in a national cohort of patients with Hinchey Ib-II diverticulitis. METHODS: The retrospective cohort-investigation was conducted using a database consisting of the entire Danish population (n = 6,641,672) in year 2000-2012, formed by linking the Danish Registers. Patients admitted with acute Hinchey Ib-II diverticulitis were identified from ICD-10 discharge codes and stratified according to treatment into an operative, drainage, and antibiotics group...
May 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/26953992/the-decline-of-elective-colectomy-following-diverticulitis-a-population-based-analysis
#20
Debbie Li, Nancy N Baxter, Robin S McLeod, Rahim Moineddin, Avery B Nathens
BACKGROUND: The indications for interval elective colectomy following diverticulitis are unclear; evidence lends increasing support for nonoperative management. OBJECTIVE: This study aims to evaluate the temporal trends in the use of elective colectomy following diverticulitis. DESIGN: This is a population-based retrospective cohort study using administrative discharge data. SETTING: This study was conducted in Ontario, Canada...
April 2016: Diseases of the Colon and Rectum
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