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. 2019 Sep;33(9):2726-2741.
doi: 10.1007/s00464-019-06882-z. Epub 2019 Jun 27.

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

Nader K Francis  1 , Patricia Sylla  2 , Maria Abou-Khalil  3 , Simone Arolfo  4 , David Berler  2 , Nathan J Curtis  5   6   7 , Scott C Dolejs  8 , Richard Garfinkle  3 , Marguerite Gorter-Stam  9 , Daniel A Hashimoto  10 , Taryn E Hassinger  11 , Charlotte J L Molenaar  12 , Philip H Pucher  13 , Valérie Schuermans  14 , Alberto Arezzo  4 , Ferdinando Agresta  15 , Stavros A Antoniou  16 , Tan Arulampalam  17 , Marylise Boutros  3 , Nicole Bouvy  14 , Kenneth Campbell  18   19 , Todd Francone  20 , Stephen P Haggerty  21   22 , Traci L Hedrick  11 , Dimitrios Stefanidis  8 , Mike S Truitt  23 , Jillian Kelly  24 , Hans Ket  9 , Brian J Dunkin  25 , Andrea Pietrabissa  26
Affiliations

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

Nader K Francis et al. Surg Endosc. 2019 Sep.

Abstract

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.

Keywords: Acute; Consensus; Diverticulitis; Elective surgery; Emergency surgery; Guidelines; Lavage.

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Conflict of interest statement

Nader K. Francis, Patricia Sylla, Maria Abou-Khalil, Simone Arolfo, David Berler, Nathan J. Curtis, Scott C. Dolejs, Richard Garfinkle, Marguerite Gorter-Stam, Daniel A. Hashimoto, Taryn E. Hassinger, Charlotte Molenaar, Philip H. Pucher, Valérie Schuermans, Alberto Arezzo, Ferdinando Agresta, Stavros A. Antoniou, Tan Arulampalam, Marylise Boutros, Nicole Bouvy, Kenneth Campbell, Todd Francone, Stephen P. Haggerty, Traci L. Hedrick, Dimitrios Stefanidis, Mike S. Truitt, Jillian Kelly, Hans Ket, Brian J. Dunkin and Andrea Pietrabissa declare that they have no conflicts of interest or financial ties to disclose.

The following authors report financial disclosures unrelated to this manuscript: NK Francis (Consultant for Medtronic and Olympus), P Sylla (Consultant for Ethicon, Medtronic, Medrobotics, Olympus, GI Supply, Boston Scientific), NJ Curtis (Consultant for Acelity), DA Hashimoto (Consultant for Google, Johnson & Johnson Institute, Gerson Lehrman Group; Research funding from Olympus), PH Pucher (Consultant for Fundamental Surgery), A Arezzo (Consultant for Karl Storz), T Francone (Consultant for Medtronic), B Dunkin (Presently employed by Boston Scientific, his contribution to this study took place before moving to this position).

Comment in

References

    1. Galetin T, Galetin A, Vestweber KH, Rink AD. Systematic review and comparison of national and international guidelines on diverticular disease. Int J Colorectal Dis. 2018;33(3):261–272. doi: 10.1007/s00384-017-2960-z. - DOI - PubMed
    1. Kohler L, Sauerland S, Neugebauer E. Diagnosis and treatment of diverticular disease: results of a consensus development conference. The Scientific Committee of the European Association for Endoscopic Surgery. Surg Endosc. 1999;13(4):430–436. doi: 10.1007/s004649901007. - DOI - PubMed
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535. doi: 10.1136/bmj.b2535. - DOI - PMC - PubMed
    1. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. doi: 10.1186/s13643-016-0384-4. - DOI - PMC - PubMed
    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–926. doi: 10.1136/bmj.39489.470347.AD. - DOI - PMC - PubMed

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