Failure of a meta-analysis on the role of elective surgery for left colonic diverticulitis in young patients

Background The timing of elective surgery of colonic diverticulitis in young patients remains controversial. The present meta-analysis aimed to answer the question whether these patients should be operated after the first attack or, more classically, after the second attack. Materials and methods Electronic databases were searched for papers reporting the results of surgery according to the strategies. Major endpoint was the performance of a colostomy (during unplanned surgery or for anastomotic dehiscence complicating elective surgery). Results Fifteen papers were selected for potential inclusion in the meta-analysis. But, eventually, only three papers gave information about the timing of surgery. Pooling the data of these 3 studies showed that 160 patients underwent elective surgery after the first attack and only 5 patients underwent subsequent emergent surgery at the course of their disease. Hence, no meta-analysis could be performed. Conclusion Researchers should no longer attempt (like us) to answer this question by any meta-analysis. The failure of the present meta-analysis highlights the limitations of evidence-based surgery in some particular fields.