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Rachelle N Damle, Julie M Flahive, Jennifer S Davids, Justin A Maykel, Paul R Sturrock, Karim Alavi
BACKGROUND: Racial disparities in outcomes are well described among surgical patients. OBJECTIVE: The purpose of this work was to identify any racial disparities in the receipt of a minimally invasive approach for colorectal surgery. DESIGN: Adults undergoing colorectal surgery were studied using the University HealthSystem Consortium. Univariate and multivariable analyses were used to identify predictors for the receipt of a minimally invasive approach...
November 2016: Diseases of the Colon and Rectum
David R Rosen, Grace S Hwang, Glenn T Ault, Adrian E Ortega, Kyle G Cologne
BACKGROUND: Diverticulitis has become a medically managed disease process; the indications and timing of surgical intervention have evolved. METHODS: We retrospectively reviewed all patients who underwent surgical intervention due to diverticular disease by the Division of Colon and Rectal Surgery from 2012 to 2014. RESULTS: Ninety-eight surgeries were performed. Indications included colovesicular fistula, multiple recurrences of diverticulitis, medically refractory diverticulitis, stricture, abscess, colocutaneous fistula, and colovaginal fistula...
August 3, 2016: American Journal of Surgery
Rasmus Gregersen, Laura Quitzau Mortensen, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
PURPOSE: This study aimed to systematically review the literature and present the evidence on outcomes after treatment for acute diverticulitis with abscess formation. Secondly, the paper aimed to compare different treatment options. METHODS: PubMed, EMBASE and the Cochrane Library were searched. Two authors screened the records independently, initially on title and abstract and subsequently on full-text basis. Articles describing patients treated acutely for Hinchey Ib and II were included...
October 11, 2016: International Journal of Surgery
Edith Lahner, Bruno Annibale
Diverticular disease (DD) is a common gastrointestinal condition. Clinical spectrum ranges from asymptomatic diverticulosis to symptomatic uncomplicated or complicated DD. Symptoms related to uncomplicated DD are not specific and may be indistinguishable from those of irritable bowel syndrome. Low-grade inflammation, altered intestinal microbiota, visceral hypersensitivity, and abnormal colonic motility have been identified as factors potentially contributing to symptoms. Probiotics may modify the gut microbial balance leading to health benefits...
November 2016: Journal of Clinical Gastroenterology
Sagar Pandey, Miao Fan, Zhe Xu, Chaogui Yan, Junfeng Zhu, Xiuhong Li
INTRODUCTION: Meckel diverticulum (MD) is the most common congenital abnormality of gastrointestinal tract. Tough believed to occur in 2% of population, most of them remain veiled because majority are clinically asymptomatic and remain obscure in radiological examination. CLINICAL FINDINGS AND DIAGNOSIS: A 26-year-old male with episodic black colored stool since last 10 years. Tough symptomatic, diagnosis of pathological lesion, and the bleeding site could not be established with any of the sophisticated diagnostic technique...
October 2016: Medicine (Baltimore)
Ting-Chia Yeh
BACKGROUND: Duodenum diverticulum is the most common site for diverticular disease of small intestine. Most of duodenal diverticulum are asymptomatic, but complicated or perforated duodenal diverticulum is rare. Nonoperative management is attractive in selected patients, because of higher surgical complications. We suggest the use of a minimally invasive operative method as an alternative approach for the management of complicated duodenal diverticulum, especially when conservative treatment has failed...
October 5, 2016: International Journal of Surgery Case Reports
Ishwarya Balasubramanian, Christina Fleming, Helen M Mohan, Karl Schmidt, Eva Haglind, Des C Winter
BACKGROUND: Management of diverticular disease has undergone a paradigm shift, with movement towards a less invasive management strategy. In keeping with this, outpatient management of uncomplicated diverticulitis (UD) has been advocated in several studies, but concerns still remain regarding the safety of this practice. AIM: To assess outcomes of out-patient management of acute UD. METHODS: A comprehensive search for published studies using the search terms 'uncomplicated diverticulitis', 'mild diverticulitis' and 'out-patient' was performed...
October 5, 2016: Digestive Surgery
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...
September 30, 2016: British Journal of Surgery
F R Bossert, L C Parsons, T Tsaltas
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Paola Soriani, Gian Eugenio Tontini, Sara Vavassori, Helmut Neumann, Luca Pastorelli, Maurizio Vecchi, Pavlos Lagoussis
No abstract text is available yet for this article.
January 2016: Endoscopy
Sho Kitagawa, Keiya Okamura, Daiki Oku, Ai Minoura
No abstract text is available yet for this article.
January 2016: Endoscopy
Rintaro Hashimoto, Akimichi Chonan
No abstract text is available yet for this article.
September 14, 2016: Clinical Gastroenterology and Hepatology
Antonio Tursi, Marcello Picchio, Walter Elisei, Francesco Di Mario, Carmelo Scarpignato, Giovanni Brandimarte
BACKGROUND: Management of diverticular disease (DD) remains a point of debate. GOALS: To investigate the current opinion of participants of the 2nd International Symposium on Diverticular Disease, on real-life management of patients with DD of the colon. STUDY: Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. RESULTS: In total, 115 surveys from 8 European Countries were filled out...
October 2016: Journal of Clinical Gastroenterology
Angelo Campanini, Umberto De Conto, Francesco Cavasin, Fernanda Bastiani, Antonio Camarotto, Luigi Gardini, Alessandra Geremia, Cristina Marastoni, Carlo Missorini, Elena Quarantelli, Umberto Sassi, Francesco Scarabello, Nadia Dal Bo, Matteo Riccò, Simone Grillo, Stefano Landi, Francesco Di Mario
INTRODUCTION: In routine colonoscopy, diverticulosis is the most commonly found feature, but only a minority of these cases show symptoms of diverticular disease.From June 2014 to December 2014, we enrolled prospectively 178 patients affected by symptomatic uncomplicated diverticular disease (Male/Female=0.47, mean age 71.7±11.5 y, range 41 to 95 y) from 15 General Pratictioners patient files. All patients were symptomatic; in all cases, diagnosis was been confirmed by a colonoscopy performed at least 1 year before...
October 2016: Journal of Clinical Gastroenterology
Antonio Tursi, Paola Mastromarino, Daniela Capobianco, Walter Elisei, Alfredo Miccheli, Giorgio Capuani, Alberta Tomassini, Giuseppe Campagna, Marcello Picchio, GianMarco Giorgetti, Federica Fabiocchi, Giovanni Brandimarte
GOAL: The aim of this study was to assess fecal microbiota and metabolome in a population with symptomatic uncomplicated diverticular disease (SUDD). BACKGROUND: Whether intestinal microbiota and metabolic profiling may be altered in patients with SUDD is unknown. PATIENTS AND METHODS: Stool samples from 44 consecutive women [15 patients with SUDD, 13 with asymptomatic diverticulosis (AD), and 16 healthy controls (HCs)] were analyzed. Real-time polymerase chain reaction was used to quantify targeted microorganisms...
October 2016: Journal of Clinical Gastroenterology
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
Knut-Arne Wensaas, Amrit Pali Hungin
Diverticular disease is a chronic and common condition, and yet the impact of diverticular disease in primary care is largely unknown. The diagnosis of diverticular disease relies on the demonstration of diverticula in the colon, and the necessary investigations are often not available in primary care. The specificity and sensitivity of symptoms, clinical signs and laboratory tests alone are generally low and consequently the diagnostic process will be characterized by uncertainty. Also, the criteria for symptomatic uncomplicated diverticular disease in the absence of macroscopic inflammation are not clearly defined...
October 2016: Journal of Clinical Gastroenterology
Alberto Biondi, Francesco Santullo, Valeria Fico, Roberto Persiani
To date, the appropriate management of diverticular disease is still controversial. The American Society of Colon and Rectal Surgeons declared that the decision between conservative or surgical approach should be taken by a case-by-case evaluation. There is still lack of evidence in literature about long-term outcomes after elective sigmoid resection for diverticular disease. Considering the potentially key role of the surgical technique in long-term outcomes, there is the need for surgeons to define strict rules to standardize the surgical technique...
October 2016: Journal of Clinical Gastroenterology
Enio C Oliveira, Mauro Bafutto, Jose R Almeida
Surgical treatment of diverticulitis is still characterized by high morbidity and mortality. Surgical approach evolved from the early 20th century with 3-stage laparotomy to colon resection with primary anastomosis. In the last 2 decades, laparoscopic colectomy has been applied to elective and emergency setting of diverticular disease. Recently, laparoscopic lavage and drainage has been used to treat purulent peritonitis. All those modalities of treatment have been discussed and pointed pros and cons.
October 2016: Journal of Clinical Gastroenterology
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
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