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Current management of diverticular disease complications

K Psarras1, N G Symeonidis, E T Pavlidis

  • 12nd Propedeutical Department of Surgery, Hippokration Hospital, A Building, 5th Floor, 49 Constantinoupoleos St, 54642 Thessaloniki, Greece. psarras_k@yahoo.com

Techniques in Coloproctology
|September 3, 2011
PubMed

Insights

Diverticular disease management is evolving, with new surgical approaches focusing on "damage limitation" and "down-staging" protocols. Further research is needed to clarify optimal surgical strategies for specific complications like peritonitis.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Diverticular disease is prevalent in Western populations, often leading to severe complications.
  • Complications include hemorrhage, obstruction, perforation, and peritonitis, necessitating surgical intervention.
  • Current surgical indications and pre-operative management strategies require clarification due to varying complication severity.

Purpose of the Study:

  • To systematically review current literature on surgical indications for complicated diverticular disease.
  • To discuss evolving surgical approaches, including "damage limitation" and "down-staging" protocols.
  • To identify areas requiring further investigation through prospective studies.

Main Methods:

  • Comprehensive literature review of existing studies on diverticular disease management.
  • Analysis of current surgical practices and their outcomes.
  • Discussion of evidence-based recommendations for surgical indications.

Main Results:

  • Advancements in imaging and minimally invasive techniques are influencing surgical indications.
  • "Damage limitation" and "down-staging" protocols show promise for improved outcomes.
  • Uncertainty remains regarding the efficacy of laparoscopic lavage for purulent peritonitis and Hartmann's procedure for fecal peritonitis.

Conclusions:

  • Surgical management of diverticular disease is adapting towards less invasive and more tailored approaches.
  • Prospective studies are essential to definitively establish optimal surgical strategies for specific complications.
  • Further research is needed to refine treatment protocols for peritonitis in diverticular disease.

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