ACPGBI Position Statement on Elective Resection for Diverticulitis

Fozard, J. B. J.; Armitage, N. C.; Schofield, J. B.; Jones, Oliver

doi:10.1111/j.1463-1318.2010.02531.x

Cited by 124 publications

(88 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Rezeksiyonsuz laparoskopik lavaj ile tedavi yaklaşımı tartışmalara açıktır. Uluslararası endoskopik ve cerrahi kuruluşların yayınladıkları kılavuzlar kolon rezeksiyonunun altın standart olduğunu ancak seçilmiş olgularda laparoskopik lavajın uygulanabileceğini belirtmektedir [37] . Belirgin peritonit bulguları olan stabil olmayan hastada veya eşlik eden ciddi yandaş hastalıkları olan hastalarda laparoskopik lavaj yaklaşımı önerilmemektedir.…”

Section: İntra-abdominal Enfeksiyonlardaunclassified

Recommendations for Intra-abdominal Infections “Consensus Report”

Avkan-Oğuz¹,

Baykam²,

Sökmen³

et al. 2018

mjima

View full text Add to dashboard Cite

Rehberler, konu ile ilgili farklı uzmanlık alanlarından uzmanların her ülkenin kendi verilerini dikkate alarak hazırladıkları önerileri içerir. Ancak ülkemizde bugüne kadar intra-abdominal enfeksiyonlar (İAE) için ortak dil oluşturmak adına, önerileri kapsayan bir rehber kullanıma sunulmamıştır. Bunun en önemli nedeni klinikte İAE'lerin tanı ve tedavisi ile ilgili veya İAE tanılı hastalardan elde edilen mikroorganizma duyarlılıklarını değerlendiren laboratuvar çalışmalarının oldukça az sayıda olmasıdır. Oysa günümüzde farklılaşan konak özellikleri ve gelişen teknolojik tedavi yöntemleri nedeniyle "ortak dil kullanmak" zorunluluk haline gelmiştir. Bu amaçla Mayıs 2015'te; Türkiye Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Uzmanlık Derneği'nin (Türkiye EKMUD) önderliğinde Türk Cerrahi Derneği, Türk Kolon ve Rektum Cerrahisi Derneği, Fıtık Derneği, Türk Hepato Pankreato Bilier Cerrahi Derneği, Türk Hastane Enfeksiyonları ve Kontrolü Derneği üyelerinden konuya ilgi duyan toplam 15 uzman tarafından yapılan toplantılarda çalışmalar değerlendirildi. Sonuçta, erişkinler için hazırlanan bu uzlaşı raporundaki öneriler, ağırlıklı olarak Amerika Enfeksiyon Hastalıkları ve Cerrahi Enfeksiyon Derneği tarafından hazırlanan erişkin ve çocuklarda komplike İAE'lerin tanısı ve yönetimi 2010 rehberi olmak üzere, ulaşılabilen rehberlerden yararlanılarak ülkemiz verileriyle hazırlandı. Öneriler; hasta ile ilk karşılaşmadan başlayarak tanısal değerlendirme ve tedavi yaklaşımı olmak üzere iki bölümde oluşturuldu. Hazırlanan uzlaşı raporu ilk kez Antalya'da Türkiye EKMUD 2016 Kongresi'nde sunuldu. Takiben bir ay süre ile derneklerin sitelerinde önerilere açıldı. Öneriler alındıktan sonra gözden geçirilerek son hali makale olarak yazıldı.

show abstract

Section: İntra-abdominal Enfeksiyonlardaunclassified

Recommendations for Intra-abdominal Infections “Consensus Report”

Avkan-Oğuz¹,

Baykam²,

Sökmen³

et al. 2018

mjima

View full text Add to dashboard Cite

show abstract

“…82 Following discharge, further assessment of the colon to exclude other pathologies notably colonic malignancy, inflammatory bowel disease and ischaemia has been recommended. 49 However, this position has been questioned in recent guidelines, given the low risk of detection of other pathologies in patients with asymptomatic disease following the acute attack. 83 Colonoscopy is the optimum approach for this if evaluation is required; however, this should be delayed to prevent the risk of perforation.…”

Section: Follow-upmentioning

confidence: 99%

“…80,81 This stance has been reflected in the current guidelines from the American Society of Colon and Rectal Surgeons, 50 along with a position statement made by the Association of Coloproctologists of Great Britain and Ireland. 49 …”

Section: Conservative/medicalmentioning

confidence: 99%

“…It is currently recommended that either CT or US scanning (depending on local expertise) should be undertaken within 72 h of admission to confirm the clinical diagnosis of acute diverticulitis and exclude any associated complications. 49,50 This position has been challenged and authors have attempted to identify severe cases that may benefit from imaging and reduce patient radiation exposure and health care costs in those with uncomplicated diverticulitis. 48 The Longstreth study found severe CT findings in just 3.8%, of those with lower rather than generalised abdominal pain and no fever or leukocytosis, suggesting that for such patients, a wait and see approach might be cost effective without CT.…”

Section: Investigationsmentioning

confidence: 99%

“…The recent ACPGBI position statement concluded that the choice between the two modalities should be made on local expertise. 49 The recent American College of Radiology Guidelines suggested CT in the first instance as US was limited by operator expertise. 52 Ultrasound, however, may have a role in premenopausal women and the young to reduce radiation exposure.…”

Section: Investigationsmentioning

confidence: 99%

See 2 more Smart Citations

Review article: the pathogenesis and management of acute colonic diverticulitis

Humes

Spiller

2014

Aliment Pharmacol Ther

View full text Add to dashboard Cite

SummaryBackgroundAcute diverticulitis, defined as acute inflammation associated with a colonic diverticulum, is a common emergency presentation managed by both surgeons and physicians. There have been advances in both the medical and the surgical treatments offered to patients in recent years.AimTo review the current understanding of the aetiology and treatment of acute diverticulitis.MethodsA search of PubMed and Medline databases was performed to identify articles relevant to the aetiology, pathogenesis and management of acute diverticulitis.ResultsThere are 75 hospital admissions per year for acute diverticulitis per 100 000 of the population in the United States. Recent reports suggest a 26% increase in admissions over a 7‐year period. Factors predisposing to the development of acute diverticulitis include obesity, smoking, diet, lack of physical activity and medication use such as aspirin and nonsteroidal anti‐inflammatory drugs. The condition is associated with a low mortality of about 1% following medical therapy, rising to 4% in‐hospital mortality in those requiring surgery. There is limited evidence on the efficacy of individual antibiotic regimens, and antibiotic treatment may not be required in all patients. The rates of recurrence reported for patients with acute diverticulitis following medical management vary from 13% to 36%. The surgical management of those patients who fail medical treatment has moved towards a laparoscopic nonresectional approach; however, the evidence supporting this is limited.ConclusionsFurther high‐quality randomised controlled trials are required of both medical and surgical treatments in patients with acute diverticulitis, if management is to be evidence‐based.

show abstract

Sigmoid Diverticulitis

Morris

Regenbogen

Hardiman

et al. 2014

JAMA

158

View full text Add to dashboard Cite

IMPORTANCE Diverticulitis is a common disease. Recent changes in understanding its natural history have substantially modified treatment paradigms.OBJECTIVE To review the etiology and natural history of diverticulitis and recent changes in treatment guidelines. EVIDENCE REVIEWWe searched the MEDLINE and Cochrane databases for English-language articles pertaining to diagnosis and management of diverticulitis published between January 1, 2000, and March 31, 2013. Search terms applied to 4 thematic topics: pathophysiology, natural history, medical management, and indications for surgery. We excluded small case series and articles based on data accrued prior to 2000. We hand searched the bibliographies of included studies, yielding a total of 186 articles for full review. We graded the level of evidence and classified recommendations by size of treatment effect, according to the guidelines from the American Heart Association Task Force on Practice Guidelines.FINDINGS Eighty articles met criteria for analysis. The pathophysiology of diverticulitis is associated with altered gut motility, increased luminal pressure, and a disordered colonic microenvironment. Several studies examined histologic commonalities with inflammatory bowel disease and irritable bowel syndrome but were focused on associative rather than causal pathways. The natural history of uncomplicated diverticulitis is often benign. For example, in a cohort study of 2366 of 3165 patients hospitalized for acute diverticulitis and followed up for 8.9 years, only 13.3% of patients had a recurrence and 3.9%, a second recurrence. In contrast to what was previously thought, the risk of septic peritonitis is reduced and not increased with each recurrence. Patient-reported outcomes studies show 20% to 35% of patients managed nonoperatively progress to chronic abdominal pain compared with 5% to 25% of patients treated operatively. Randomized trials and cohort studies have shown that antibiotics and fiber were not as beneficial as previously thought and that mesalamine might be useful. Surgical therapy for chronic disease is not always warranted. CONCLUSIONS AND RELEVANCERecent studies demonstrate a lesser role for aggressive antibiotic or surgical intervention for chronic or recurrent diverticulitis than was previously thought necessary.

show abstract

ACPGBI Position Statement on Elective Resection for Diverticulitis

Cited by 124 publications

References 81 publications

Recommendations for Intra-abdominal Infections “Consensus Report”

Recommendations for Intra-abdominal Infections “Consensus Report”

Review article: the pathogenesis and management of acute colonic diverticulitis

Sigmoid Diverticulitis

Contact Info

Product

Resources

About