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Diverticular disease of the colon –  new trends in therapy


Authors: O. Ryska
Authors‘ workplace: Chirurgické oddělení, Nemocnice Hořovice
Published in: Kardiol Rev Int Med 2014, 16(3): 229-234
Category: Internal Medicine

Overview

Diverticular disease is a frequent bowel disease with an increasing incidence, especially in Western countries. It covers a wide spectrum of symptoms and pos­sible complications for which there is still no comprehensive classification. The treatment of chronic or recurrent disease is not resolved and so far there are no high‑quality prospective studies evaluating the conventional algorithms. New trends in the surgical treatment focus on some less invasive procedures that may be beneficial for the patient. However, there is a lack of data supporting their introduction into clinical practice. This paper summarizes some of the new trends in the treatment of colonic diverticular disease on the basis of the principles of evidence‑based medicine.

Keywords:
diverticulosis –  diverticulitis –  classification –  antibio­tics –  laparoscopy


Sources

1. Young‑ Fadok TM, Roberts PL, Spencer MP et al. Colonic diverticular disease. Curr Probl Surg 2000; 37: 457– 514.

2. Jung HK, Choung RS, Locke GR et al. Diarrhea‑ predominant irritable bowel syndrome is associated with diverticular disease: a population‑based study. Am J Gastroenterol 2010; 105: 652– 661. doi: 10.1038/ ajg.2009.621.

3. Laméris W, van Randen A, van Gulik T et al. A clinical decision rule to establish the dia­gnosis of acute diverticulitis at the emergency department. Dis Colon Rectum 2010; 53: 896– 904. doi: 10.1007/ DCR.0b013e3181d98d86.

4. Schwerk W, Schwarz S, Rothmund M. Sonography in acute colonic diverticulitis. A prospective study. Dis Colon Rectum 1992; 35: 1077– 1084.

5. Ritz J, Lehmann KS, Loddenkemper C et al. Preoperative CT staging in sigmoid diverticulitis –  does it correlate with intraoperative and histological findings? Langenbecks Arch Surg 2010; 395: 1009– 1015. doi: 10.1007/ s00423‑ 010‑ 0609‑ 2.

6. Green BT, Rockey DC, Portwood G et al. Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial. Am J Gastroenterol 2005; 100: 2395– 2402.

7. Kaltenbach T, Watson R, Shah J et al. Colonoscopy with clipping is useful in the dia­gnosis and treatment of diverticular bleeding. Clin Gastroenterol Hepatol 2012; 10: 131– 137. doi: 10.1016/ j.cgh.2011.10.029.

8. Khanna A, Ognibene SJ, Koniaris LG. Embolization as first‑line therapy for diverticulosis‑related massive lower gastrointestinal bleeding: evidence from a meta‑analysis. J Gastrointest Surg 2005; 9: 343– 352.

9. Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. Adv Surg 1978; 12: 85– 109.

10. Hansen O, Graupe F, Stock W. Prognostic factors in perforating diverticulitis of the large intestine. Chirurg 1998; 69: 443– 449.

11. Leifeld L, Böhm B, Germer CT et al. S2k‑ Leitlinie Divertikelkrankheit –  Divertikulitis. Z Gastroenterol 2014 in press.

12. Sher ME, Agachan F, Bortul M et al. Laparoscopic surgery for diverticulitis. Surg Endosc 1997; 11: 264– 267.

13. Wasvary H, Turfah F, Kadro O et al. Same hospitalization resection for acute diverticulitis. Am Surg 1999; 65: 632– 635.

14. Aldoori WH, Giovannucci EL, Rimm EB et al. Use of acetaminophen and nonsteroidal anti‑inflammatory drugs: a prospective study and the risk of symptomatic diverticular disease in men. Arch Fam Med 1998; 7: 255– 260.

15. Peery AF, Barrett PR, Park D et al. A high‑fiber diet does not protect against asymptomatic diverticulosis. Gastroenterology 2012; 142: 266– 272. doi: 10.1053/ j.gastro.2011.10.035.

16. Crowe FL, Appleby PN, Allen NE et al. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non‑vegetarians. BMJ 2011; 343: d4131. doi: 10.1136/ bmj.d4131.

17. Hjern F, Wolk A, Hakansson N. Obesity, physical inactivity, and colonic diverticular disease requir­ing hospitalization in women: a prospective cohort study. Am J Gastroenterol 2012; 107: 296– 302. doi: 10.1038/ ajg.2011.352.

18. Chabok A, Pahlman L, Hjern F et al. Randomized clinical trial of antibio­tics in acute uncomplicated diverticulitis. Br J Surg 2012; 99: 532– 539. doi: 10.1002/ bjs.8688.

19. de Korte N, Kuyvenhoven JP, van der Peet DL et al. Mild colonic diverticulitis can be treated without antibio­tics. Colorectal Dis 2012; 14: 325– 330. doi: 10.1111/ j.1463‑ 1318.2011.02609.x.

20. Stollman N, Magowan S, Shanahan F et al. A randomized controlled study of mesalamine after acute diverticulitis. J Clin Gastroenterol 2013; 47: 621– 629. doi: 10.1097/ MCG.0b013e31828003f6.

21. Kruis W, Meier E, Schumacher M et al. Randomised clinical trial: mesalazine (Salofalk granules) for uncomplicated diverticular disease of the colon –  a placebo‑ controlled study. Aliment Pharmacol Ther 2013; 37: 680– 690. doi: 10.1111/ apt.12248.

22. Tursi A, Brandimarte G, Giorgetti GM et al. Mesalazine and/ or Lactobacillus casei in preventing recurrence of symptomatic uncomplicated diverticular disease of the colon. J Clin Gastroenterol 2006; 40: 312– 316.

23. Tursi A, Brandimarte G, Giorgetti GM et al. Mesalazine and/ or Lactobacillus casei in maintaining long‑term remission of symptomatic uncomplicated diverticular disease of the colon. Hepatogastroenterology 2008; 55: 916– 920.

24. Fric P, Zavoral M. The effect of non‑pathogenic Escherichia coli in symptomatic uncomplicated diverticular disease of the colon. Eur J Gastroenterol Hepatol 2003; 15: 313– 315.

25. Chapman JR, Dozois EJ, Wolff BG et al. Diverticulitis: a progressive disease? Do multiple recurrences predict less favorable outcomes? Ann Surg 2006; 243: 876– 830.

26. Ricciardi R, Baxter NN, Read TE et al. Is the decline in the surgical treatment for diverticulitis associated with an increase in complicated diverticulitis? Dis Colon Rectum 2009; 52: 1558– 1563. doi: 10.1007/ DCR.0b013e3181a90a5b.

27. Klarenbeek BR, Samuels M, van der Wal MA et al. Indications for elective sigmoid resection in diverticular disease. Ann Surg 2010; 251: 670– 674. doi: 10.1097/ SLA.0b013e3181d3447d.

28. Ambrosetti P. Acute diverticulitis of the left colon: value of the initial CT and timing of elective colectomy. J Gastrointest Surg 2008; 12: 1318– 1320. doi: 10.1007/ s11605‑ 008‑ 0489‑ 8.

29. Zingg U, Pasternak I, Guertler L et al. Early vs. delayed elective laparoscopicassisted colectomy in sigmoid diverticulitis: timing of surgery in relation to the acute attack. Dis Colon Rectum 2007; 50: 1911– 1917.

30. Reissfelder C, Buhr HJ, Ritz JP. What is the optimal time of surgical intervention after an acute attack of sigmoid diverticulitis: early or late elective laparoscopic resection? Dis Colon Rectum 2006; 49: 1842– 1848.

31. Murphy T, Hunt RH, Fried M et al. World Gastroenterology Organisation Practice Guidelines: Diverticular disease. 2007. [online] Available from: http: / / www.worldgastroenterology.org/ assets/ downloads/ en/ pdf/ guidelines/ 07_diverticular_disease.pdf.

32. Thaler K, Baig MK, Berho M et al. Determinants of recurrence after sigmoid resection for uncomplicated diverticulitis. Dis Colon Rectum 2003; 46: 385– 388.

33. Siddiqui MR, Sajid MS, Khatri K et al. Elective open versus laparoscopic sigmoid colectomy for diverticular disease: a meta‑analysis with the Sigma trial. World J Surg 2010; 34: 2883– 2901. doi: 10.1007/ s00268‑ 010‑ 0762‑ 3.

34. Klarenbeek BR, Bergamaschi R, Veenhof AA et al. Laparoscopic versus open sigmoid resection for diverticular disease: follow‑up assessment of the randomized control Sigma trial. Surg Endosc 2011; 25: 1121– 1126. doi: 10.1007/ s00464‑ 010‑ 1327‑ 0.

35. Gervaz P, Mugnier‑ Konrad B, Morel P et al. Laparoscopic versus open sigmoid resection for diverticulitis: long‑term results of a prospective, randomized trial. Surg Endosc 2011; 25: 3373– 3378. doi: 10.1007/ s00464‑ 011‑ 1728‑ 8.

36. Antoš F. Divertikulární choroba tlustého střeva. Praha: Avicenum 1990.

37. Salem L, Flum DR. Primary anastomosis or Hartmann’s procedure for patients with diverticular peritonitis? A systematic review. Dis Colon Rectum 2004; 47: 1953– 1964.

38. Binda GA, Karas JR, Serventi A et al. Primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial. Colorectal Dis 2012; 14: 1403– 1410. doi: 10.1111/ j.1463‑ 1318.2012.03117.x.

39. Constantinides VA, Tekkis PP, Athanasiou T et al. Primary resection with anastomosis ves. Hartmann’s procedure in nonelective surgery for acute colonic diverticulitis: a systematic review. Dis Colon Rectum 2006; 49: 966– 981.

40. Abbas S. Resection and primary anastomosis in acute complicated diverticulitis, a systematic review of the literature. Int J Colorectal Dis 2007; 22: 351– 357.

41. Oberkofler CE, Rickenbacher A, Raptis DA et al. A multicenter randomized clinical trial of primary anastomosis or Hartmann’s procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg 2012; 256: 819– 826. doi: 10.1097/ SLA.0b013e31827324ba.

42. Toorenvliet BR, Swank H, Schoones JW et al. Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a systematic review. Colorectal Dis 2010; 12: 862– 867. doi: 10.1111/ j.1463‑ 1318.2009.02052.x.

43. Zonca P, Ihnat P, Peteja M et al. Laparoscopic lavage and drainage in the management of acute diverticulitis: is it time to move on? Rozhl Chir 2013; 92: 634– 639.

44. Perathoner A1, Klaus A, Mühlmann G et al. Damage control with abdominal vacuum therapy (VAC) to manage perforated diverticulitis with advanced generalized peritonitis –  a proof of concept. Int J Colorectal Dis 2010; 25: 767– 774. doi: 10.1007/ s00384‑ 010‑ 0887‑ 8.

45. Serclová Z, Ryska O, Dytrych P et al. Fascial closure of the abdominal wall by dynamic suture after topical negative pressure laparostomy treatment of severe peritonitis –  results of a prospective randomized study. Rozhl Chir 2012; 91: 26– 31.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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