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Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors
PURPOSE: Fifteen percent of patients undergoing elective sigmoidectomy will present a diverticulitis recurrence, which is associated with significant costs and morbidity. We aimed to systematically review the risk factors associated with recurrence after elective sigmoidectomy. METHODS: PubMed/MEDLI...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801345/ https://www.ncbi.nlm.nih.gov/pubmed/32989503 http://dx.doi.org/10.1007/s00384-020-03762-0 |
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author | Longchamp, Gregoire Abbassi, Ziad Meyer, Jeremy Toso, Christian Buchs, Nicolas C. Ris, Frederic |
author_facet | Longchamp, Gregoire Abbassi, Ziad Meyer, Jeremy Toso, Christian Buchs, Nicolas C. Ris, Frederic |
author_sort | Longchamp, Gregoire |
collection | PubMed |
description | PURPOSE: Fifteen percent of patients undergoing elective sigmoidectomy will present a diverticulitis recurrence, which is associated with significant costs and morbidity. We aimed to systematically review the risk factors associated with recurrence after elective sigmoidectomy. METHODS: PubMed/MEDLINE, Embase, Cochrane, and Web of Science were searched for studies published until May 1, 2020. Original studies were included if (i) they included patients undergoing sigmoidectomy for diverticular disease, (ii) they reported postoperative recurrent diverticulitis, and (iii) they analyzed ≥ 1 variable associated with recurrence. The primary outcome was the risk factors for recurrence of diverticulitis after sigmoidectomy. RESULTS: From the 1463 studies initially screened, six studies were included. From the 1062 patients included, 62 patients recurred (5.8%), and six variables were associated with recurrence. Two were preoperative: age (HR = 0.96, p = 0.02) and irritable bowel syndrome (33.3% with recurrence versus 12.1% without recurrence, p = 0.02). Two were operative factors: uncomplicated recurrent diverticulitis as indication for surgery (73.3% with recurrence versus 49.9% without recurrence, p = 0.049) and anastomotic level (colorectal: HR = 11.4, p = 0.02, or colosigmoid: OR = 4, p = 0.033). Two were postoperative variables: the absence of active diverticulitis on pathology (39.6% with recurrence versus 26.6% without recurrence) and persistence of postoperative pain (HR = 4.8, p < 0.01). CONCLUSION: Identification of preoperative variables that predict the occurrence of diverticulitis recurrence should help surgical decision-making for elective sigmoidectomy, while peri- and postoperative factors should be taken into account for optimal patient follow-up. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00384-020-03762-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7801345 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-78013452021-01-21 Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors Longchamp, Gregoire Abbassi, Ziad Meyer, Jeremy Toso, Christian Buchs, Nicolas C. Ris, Frederic Int J Colorectal Dis Review PURPOSE: Fifteen percent of patients undergoing elective sigmoidectomy will present a diverticulitis recurrence, which is associated with significant costs and morbidity. We aimed to systematically review the risk factors associated with recurrence after elective sigmoidectomy. METHODS: PubMed/MEDLINE, Embase, Cochrane, and Web of Science were searched for studies published until May 1, 2020. Original studies were included if (i) they included patients undergoing sigmoidectomy for diverticular disease, (ii) they reported postoperative recurrent diverticulitis, and (iii) they analyzed ≥ 1 variable associated with recurrence. The primary outcome was the risk factors for recurrence of diverticulitis after sigmoidectomy. RESULTS: From the 1463 studies initially screened, six studies were included. From the 1062 patients included, 62 patients recurred (5.8%), and six variables were associated with recurrence. Two were preoperative: age (HR = 0.96, p = 0.02) and irritable bowel syndrome (33.3% with recurrence versus 12.1% without recurrence, p = 0.02). Two were operative factors: uncomplicated recurrent diverticulitis as indication for surgery (73.3% with recurrence versus 49.9% without recurrence, p = 0.049) and anastomotic level (colorectal: HR = 11.4, p = 0.02, or colosigmoid: OR = 4, p = 0.033). Two were postoperative variables: the absence of active diverticulitis on pathology (39.6% with recurrence versus 26.6% without recurrence) and persistence of postoperative pain (HR = 4.8, p < 0.01). CONCLUSION: Identification of preoperative variables that predict the occurrence of diverticulitis recurrence should help surgical decision-making for elective sigmoidectomy, while peri- and postoperative factors should be taken into account for optimal patient follow-up. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00384-020-03762-0) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-09-28 2021 /pmc/articles/PMC7801345/ /pubmed/32989503 http://dx.doi.org/10.1007/s00384-020-03762-0 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Review Longchamp, Gregoire Abbassi, Ziad Meyer, Jeremy Toso, Christian Buchs, Nicolas C. Ris, Frederic Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors |
title | Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors |
title_full | Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors |
title_fullStr | Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors |
title_full_unstemmed | Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors |
title_short | Surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors |
title_sort | surgical resection does not avoid the risk of diverticulitis recurrence—a systematic review of risk factors |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801345/ https://www.ncbi.nlm.nih.gov/pubmed/32989503 http://dx.doi.org/10.1007/s00384-020-03762-0 |
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