التفاصيل البيبلوغرافية
| العنوان: |
Nonoperative management of acute complicated diverticulitis with pericolic and/or distant extraluminal air: A systematic review. |
| المؤلفون: |
Morini, Andrea1 (AUTHOR) andrea.morini@ausl.re.it, Zizzo, Maurizio1 (AUTHOR), Tumiati, David1 (AUTHOR), Mereu, Federica1 (AUTHOR), Bernini, Diego2 (AUTHOR), Fabozzi, Massimiliano1 (AUTHOR) |
| المصدر: |
World Journal of Surgery. Aug2024, Vol. 48 Issue 8, p2000-2015. 16p. |
| مستخلص: |
Introduction: Colonic Diverticular Disease (CDD) is a multifactorial inflammatory disease. Acute diverticulitis (AD), with extraluminal free air (both pericolic and distant), represents about 15% of radiological scenarios and remains a therapeutic challenge for surgeons. Currently, the WSES guidelines suggest trying a conservative strategy both in the presence of pericolic and distant free extraluminal air, even if both have respectively weak recommendation based on low/very low‐quality evidence. Methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyzes guidelines. PubMed/MEDLINE, Scopus, Web of Science, and Embase databases were used to identify articles of interest. Results: A total of 2380 patients with AD and extraluminal free air (both pericolic and distant) who underwent nonoperative management (NOM) were analyzed. Of the 2380 patients, 2095(88%) were successfully treated with NOM, while 285 (12%) patients failed. A total of 1574 (93.1%) patients with pericolic extraluminal free air had a successful NOM with 6.9% (117) failure rates, while 135 (71.1%) patients with distant extraluminal free air had a successful NOM with 28.9% (55) failure rates. Regarding distant recurrence, we recorded a rate of 18.3% (261/1430), while a rate of 11.3% (167/1472) was recorded for patients undergoing elective surgery. Conclusion: NOM for patients with AD and extraluminal free air (both pericolic and distant) seems to be feasible and safe despite a higher failure rate in the distant subgroup, which remains the most challenging clinical scenario to deal with through conservative treatment. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
Academic Search Index |