“…A total of 68 studies with 13 905 patients were included 6,24–90 . There were four prospective studies and one retrospective review of a prospective study 44,60,61,77,89 .…”
Section: Resultsmentioning
confidence: 99%
“…There were 13 296 patients from 65 studies who underwent a follow up colonoscopy 6,24–42,44–65,67–79,81–90 . The remaining three studies (231 patients) reported follow up with either a colonoscopy or flexible sigmoidoscopy and did not differentiate between the two 43,66,80 .…”
Section: Resultsmentioning
confidence: 99%
“…There were ten high quality studies which scored greater than or equal to 7 (see Tables S1, S2). 6,25,40,41,44,49,58,63,65,78 Follow up was greater than 80% in 25 studies 25,29,31–33,39,41,44,45,49,53–55,60,61,63,67,71,74,77–80,86,89 …”
Section: Resultsmentioning
confidence: 99%
“…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][87][88]…”
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.…”
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.
“…A total of 68 studies with 13 905 patients were included 6,24–90 . There were four prospective studies and one retrospective review of a prospective study 44,60,61,77,89 .…”
Section: Resultsmentioning
confidence: 99%
“…There were 13 296 patients from 65 studies who underwent a follow up colonoscopy 6,24–42,44–65,67–79,81–90 . The remaining three studies (231 patients) reported follow up with either a colonoscopy or flexible sigmoidoscopy and did not differentiate between the two 43,66,80 .…”
Section: Resultsmentioning
confidence: 99%
“…There were ten high quality studies which scored greater than or equal to 7 (see Tables S1, S2). 6,25,40,41,44,49,58,63,65,78 Follow up was greater than 80% in 25 studies 25,29,31–33,39,41,44,45,49,53–55,60,61,63,67,71,74,77–80,86,89 …”
Section: Resultsmentioning
confidence: 99%
“…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][87][88]…”
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.…”
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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