EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice

被引：129

作者：

Francis, Nader K. ^{[1
]}

Sylla, Patricia ^{[2
]}

Abou-Khalil, Maria ^{[3
]}

Arolfo, Simone ^{[4
]}

Berler, David ^{[2
]}

Curtis, Nathan J. ^{[1
,5
,11
]}

Dolejs, Scott C. ^{[6
]}

Garfinkle, Richard ^{[3
]}

Gorter-Stam, Marguerite ^{[7
]}

Hashimoto, Daniel A. ^{[8
]}

Hassinger, Taryn E. ^{[9
]}

Molenaar, Charlotte J. L. ^{[10
]}

Pucher, Philip H. ^{[11
]}

Schuermans, Valerie ^{[12
]}

Arezzo, Alberto ^{[4
]}

Agresta, Ferdinando ^{[13
]}

Antoniou, Stavros A. ^{[14
]}

Arulampalam, Tan ^{[15
]}

Boutros, Marylise ^{[3
]}

Bouvy, Nicole ^{[12
]}

Campbell, Kenneth ^{[16
,17
]}

Francone, Todd ^{[18
]}

Haggerty, Stephen P. ^{[19
,20
]}

Hedrick, Traci L. ^{[9
]}

Stefanidis, Dimitrios ^{[6
]}

Truitt, Mike S. ^{[21
]}

Kelly, Jillian ^{[22
]}

Ket, Hans ^{[7
]}

Dunkin, Brian J. ^{[23
]}

Pietrabissa, Andrea ^{[24
]}

机构：

[1] Yeovil Dist Hosp NHS Fdn Trust, Dept Gen Surg, Yeovil, England

[2] Mt Sinai Hosp, Div Colon & Rectal Surg, New York, NY 10029 USA

[3] McGill Univ, Jewish Gen Hosp, Div Colon & Rectal Surg, Montreal, PQ, Canada

[4] Univ Torino, Dept Surg Sci, Toriano, Italy

[5] Imperial Coll London, Dept Surg & Canc, London, England

[6] Indiana Univ Sch Med, Dept Surg, Indianapolis, IN 46202 USA

[7] Vrije Univ Amsterdam, Dept Surg, Med Ctr, Amsterdam, Netherlands

[8] Massachusetts Gen Hosp, Dept Surg, Boston, MA 02114 USA

[9] Univ Virginia Hlth Syst, Dept Surg, Charlottesville, VA USA

[10] Spaarne Gasthuis, Dept Surg, Hoofddorp, Netherlands

[11] Portsmouth Hosp NHS Trust, Dept Gen Surg, Portsmouth, Hants, England

[12] Maastricht Univ, Dept Surg, Med Ctr, Maastricht, Netherlands

[13] ULSS5 Veneto, Dept Gen Surg, Adria, Italy

[14] European Univ Cyprus, Dept Surg, Nicosia, Cyprus

[15] Colchester Gen Hosp, Dept Gen Surg, Colchester, Essex, England

[16] Ninewells Hosp, Dept Surg, Dundee, Scotland

[17] Univ Dundee, Sch Med, Dundee, Scotland

[18] Newton Wellesley Hosp, Div Colon & Rectal Surg, Newton, MA USA

[19] NorthShore Univ Hlth Syst, Div Gen Surg, Evanston, IL USA

[20] Univ Chicago, Pritzker Sch Med, Chicago, IL 60637 USA

[21] Methodist Dallas Med Ctr, Colchester, TX USA

[22] SAGES, Los Angeles, CA USA

[23] Houston Methodist Hosp, Dept Surg, Houston, TX USA

[24] Fdn IRCCS Policlin San Matteo, Dept Surg, Pavia, Italy

来源：

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2019年 / 33卷 / 09期

关键词：

Diverticulitis; Acute; Elective surgery; Emergency surgery; Lavage; Consensus; Guidelines; DIAGNOSIS;

D O I：

10.1007/s00464-019-06882-z

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background Acute diverticulitis (AD) presents a unique diagnostic and therapeutic challenge for general surgeons. This collaborative project between EAES and SAGES aimed to summarize recent evidence and draw statements of recommendation to guide our members on comprehensive AD management. Methods Systematic reviews of the literature were conducted across six AD topics by an international steering group including experts from both societies. Topics encompassed the epidemiology, diagnosis, management of non-complicated and complicated AD as well as emergency and elective operative AD management. Consensus statements and recommendations were generated, and the quality of the evidence and recommendation strength rated with the GRADE system. Modified Delphi methodology was used to reach consensus among experts prior to surveying the EAES and SAGES membership on the recommendations and likelihood to impact their practice. Results were presented at both EAES and SAGES annual meetings with live re-voting carried out for recommendations with < 70% agreement. Results A total of 51 consensus statements and 41 recommendations across all six topics were agreed upon by the experts and submitted for members' online voting. Based on 1004 complete surveys and over 300 live votes at the SAGES and EAES Diverticulitis Consensus Conference (DCC), consensus was achieved for 97.6% (40/41) of recommendations with 92% (38/41) agreement on the likelihood that these recommendations would change practice if not already applied. Areas of persistent disagreement included the selective use of imaging to guide AD diagnosis, recommendations against antibiotics in non-complicated AD, and routine colonic evaluation after resolution of non-complicated diverticulitis. Conclusion This joint EAES and SAGES consensus conference updates clinicians on the current evidence and provides a set of recommendations that can guide clinical AD management practice.

引用

页码：2726 / 2741

页数：16

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