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

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Title: EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice
Authors: Francis, NK
Sylla, P
Abou-Khalil, M
Arolfo, S
Berler, D
Curtis, NJ
Dolejs, SC
Garfinkle, R
Gorter-Stam, M
Hashimoto, DA
Hassinger, TE
Molenaar, CJL
Pucher, PH
Schuermans, V
Arezzo, A
Agresta, F
Antoniou, SA
Arulampalam, T
Boutros, M
Bouvy, N
Campbell, K
Francone, T
Haggerty, SP
Hedrick, TL
Stefanidis, D
Truitt, MS
Kelly, J
Ket, H
Dunkin, BJ
Pietrabissa, A
Item Type: Journal Article
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.
Issue Date: 1-Sep-2019
Date of Acceptance: 29-May-2019
URI: http://hdl.handle.net/10044/1/73038
DOI: https://dx.doi.org/10.1007/s00464-019-06882-z
ISSN: 0930-2794
Publisher: Springer Verlag
Start Page: 2726
End Page: 2741
Journal / Book Title: Surgical Endoscopy
Volume: 33
Issue: 9
Copyright Statement: © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Science & Technology
Life Sciences & Biomedicine
Surgery
Diverticulitis
Acute
Elective surgery
Emergency surgery
Lavage
Consensus
Guidelines
DIAGNOSIS
Acute
Consensus
Diverticulitis
Elective surgery
Emergency surgery
Guidelines
Lavage
Science & Technology
Life Sciences & Biomedicine
Surgery
Diverticulitis
Acute
Elective surgery
Emergency surgery
Lavage
Consensus
Guidelines
DIAGNOSIS
1103 Clinical Sciences
Surgery
Publication Status: Published
Online Publication Date: 2019-06-27
Appears in Collections:Department of Surgery and Cancer