Journal of Surgery Concepts & Practice >

2024 , Vol. 29 >Issue 01: 87 - 92

DOI: https://doi.org/10.16139/j.1007-9610.2024.01.14

Review

Progress in the treatment of colonic diverticular diseases

Expand
  • Department of Surgery; b. Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201821, China

Received date: 2023-06-20

  Online published: 2024-05-14

Fold

Abstract

The incidence of colonic diverticular disease is increasing significantly and is showing a trend of youthfulness. The treatment of colonic diverticulum disease mainly involves drugs, including antibiotics, rifaximin, and mesalazine. In addition, probiotics and dietary fiber are believed to have a positive impact on the treatment of diverticular diseases. When it progresses to acute complicated diverticulitis, surgical treatment becomes a necessary means. Up to now, our country has not formulated standards and guidelines of the diagnosis and treatment for colonic diverticulitis.

Key words： Colonic diverticulum; Diverticulitis; Drug therapy; Surgical treatment

Cite this article

KONG Lei, YANG Huali . Progress in the treatment of colonic diverticular diseases[J]. Journal of Surgery Concepts & Practice, 2024 , 29(01) : 87 -92 . DOI: 10.16139/j.1007-9610.2024.01.14

References

[1] NAGATA N, ISHII N, MANABE N, et al. Guidelines for colonic diverticular bleeding and colonic diverticulitis: Japan gastroenterological association[J]. Digestion, 2019, 99 (Suppl 1):1-26.
[2] REZAPOUR M, ALI S, STOLLMAN N. Diverticular di-sease: an update on pathogenesis and management[J]. Gut Liver, 2018, 12(2):125-132.
[3] PEERY A F. Management of colonic diverticulitis[J]. BMJ, 2021,372:n72.
[4] BROAD J B, WU Z, XIE S, et al. Diverticular disease epidemiology: acute hospitalisations are growing fastest in young men[J]. Tech Coloproctol, 2019, 23(8):713-721.
[5] CALINI G, ABD EL AZIZ M A, PAOLINI L, et al. Symptomatic uncomplicated diverticular disease (SUDD): practical guidance and challenges for clinical management[J]. Clin Exp Gastroenterol, 2023,16:29-43.
[6] SCH?FER A O. Divertikelkrankheit: stadiengerechte bildgebende Diagnostik [Diverticular disease: stage-related diagnostic imaging][J]. Chirurg, 2021, 92(8):688-693.
[7] SARTELLI M, WEBER D G, KLUGER Y, et al. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting[J]. World J Emerg Surg, 2020, 15(1):32.
[8] KRUIS W, GERMER C T, B?HM S, et al. German guideline diverticular disease/diverticulitis: part Ⅱ: conservative, interventional and surgical management[J]. United European Gastroenterol J, 2022, 10(9):940-957.
[9] SCHECHTER S, MULVEY J, EISENSTAT T E. Management of uncomplicated acute diverticulitis: results of a survey[J]. Dis Colon Rectum, 1999, 42(4):470-475.
[10] DANIELS L, üNLü ?, DE KORTE N, et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT‐proven uncomplicated acute diverticulitis[J]. Br J Surg, 2017, 104(1):52-61.
[11] JAUNG R, NISBET S, GOSSELINK M P, et al. Antibio-tics do not reduce length of hospital stay for uncomplicated diverticulitis in a pragmatic double-blind rando-mized trial[J]. Clin Gastroenterol Hepatol, 2021, 19(3):503-510.
[12] ISACSON D, SMEDH K, NIKBERG M, et al. Long‐term follow‐up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis[J]. Br J Surg, 2019 ;106(11):1542-1548.
[13] DICHMAN M L, ROSENSTOCK S J, SHABANZADEH D M. Antibiotics for uncomplicated diverticulitis[J]. Cochrane Database Syst Rev, 2022,6:CD009092.
[14] EMILE S H, ELFEKI H, SAKR A, et al. Management of acute uncomplicated diverticulitis without antibiotics: a systematic review, meta‐analysis, and meta‐regression of predictors of treatment failure[J]. Tech Coloproctol, 2018, 22(7):499-509.
[15] CHOKSEY R, STEAD T S, MANGAL R, et al. Diverticulitis with microperforation[J]. Cureus, 2022, 14(7):e27159.
[16] QASEEM A, ETXEANDIA-IKOBALTZETA I, LIN J S, et al. Diagnosis and management of acute left-sided colonic diverticulitis: a clinical guideline from the American College of Physicians[J]. Ann Intern Med, 2022, 175(3):399-415.
[17] PEERY A F, SHAUKAT A, STRATE L L. AGA clinical practice update on medical management of colonic diverticulitis: expert review[J]. Gastroenterology, 2021, 160(3):906-911.
[18] DI MARIO F, MIRAGLIA C, CAMBIE G, et al. Long‐term efficacy of rifaximin to manage the symptomatic uncomplicated diverticular disease of the colon[J]. J Investig Med, 2019, 67(4):767-770.
[19] COPACI I, CONSTANTINESCU G, MIHAILA M, et al. Efficacy of rifaximin‐a vs. dietary fiber on the evolution of uncomplicated colonic diverticular disease[J]. Surg Gastroenerol Oncol, 2019, 24(5):233-240.
[20] CARABOTTI M, ANNIBALE B. Treatment of diverticular disease: an update on latest evidence and clinical implications[J]. Drugs Context, 2018,7:212526.
[21] CUOMO R, BARBARA G, ANNIBALE B. Rifaximin and diverticular disease: position paper of the Italian Society of Gastroenterology (SIGE)[J]. Dig Liver Dis, 2017, 49(6):595-603.
[22] PICCIN A, GULOTTA M, DI BELLA S, et al. Diverticular disease and rifaximin: an evidence-based review[J]. Antibiotics (Basel), 2023, 12(3):443.
[23] CALINI G, ABD EL AZIZ M A, PAOLINI L, et al. Symptomatic uncomplicated diverticular disease (SUDD): practical guidance and challenges for clinical management[J]. Clin Exp Gastroenterol, 2023,16:29-43.
[24] IANNONE A, RUOSPO M, WONG G, et al. Mesalazine for people with diverticular disease: a systematic review of randomized controlled trials[J]. Can J Gastroenterol Hepatol, 2018,2018:5437135.
[25] 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[J]. Aliment Pharmacol Ther, 2013, 37(7):680-690.
[26] DI MARIO F, ARAGONA G, LEANDRO G, et al. Efficacy of mesalazine in the treatment of symptomatic diverticular disease[J]. Dig Dis Sci, 2005, 50(3):581-586.
[27] COMPARATO G, FANIGLIULO L, CAVALLARO L G, et al. Prevention of complications and symptomatic recurrences in diverticular disease with mesalazine: a 12‐month follow‐up[J]. Dig Dis Sci, 2007, 52(11):2934-2941.
[28] PICCHIO M, ELISEI W, BRANDIMARTE G, et al. Mesalazine for the treatment of symptomatic uncomplicated diverticular disease of the colon and for primary prevention of diverticulitis: a systematic review of randomized clinical trials[J]. J Clin Gastroenterol, 2016, 50(Suppl 1):S64-S69.
[29] KRUIS W, KARDALINOS V, EISENBACH T, et al. Randomised clinical trial: mesalazine versus placebo in the prevention of diverticulitis recurrence[J]. Aliment Pharmacol Ther, 2017, 46(3):282-291.
[30] STEFANELLI G, VISCIDO A, VALVANO M, et al. Is mesalazine treatment effective in the prevention of diverticulitis? A review[J]. Eur Rev Med Pharmacol Sci, 2020, 24(15):8164-8176.
[31] CHENG F S, PAN D, CHANG B, et al. Probiotic mixture VSL#3: an overview of basic and clinical studies in chronic diseases[J]. World J Clin Cases, 2020, 8(8):1361-1384.
[32] TURSI A, PAPA V, LOPETUSO L R, et al. Microbiota composition in diverticular disease: implications for therapy[J]. Int J Mol Sci, 2022, 23(23):14799.
[33] OJETTI V, SAVIANO A, BRIGIDA M, et al. Randomized control trial on the efficacy of Limosilactobacillus reuteri ATCC PTA 4659 in reducing inflammatory markers in acute uncomplicated diverticulitis[J]. Eur J Gastroenterol Hepatol, 2022, 34(5),496-502.
[34] PETRUZZIELLO C, MIGNECO A, CARDONE S, et al. Supplementation with Lactobacillus reuteri ATCC PTA 4659 in patients affected by acute uncomplicated diverticulitis: a randomized double‐blind placebo controlled trial[J]. Int J Colorectal Dis, 2019, 34(6):1087-1094.
[35] STOLLMAN N, MAGOWAN S, SHANAHAN F, et al. A randomized controlled study of mesalamine after acute diverticulitis: results of the DIVA trial[J]. J Clin Gastroenterol, 2013, 47(7):621-629.
[36] KVASNOVSKY C L, BJARNASON I, DONALDSON A N, et al. A randomized double‐blind placebo‐controlled trial of a multi‐strain probiotic in treatment of symptomatic uncomplicated diverticular disease[J]. Inflammopharmacology, 2017, 25(5):499-509.
[37] OJETTI V, PETRUZZIELLO C, CARDONE S, et al. The use of probiotics in different phases of diverticular disease[J]. Rev Recent Clin Trials, 2018, 13(2):89-96.
[38] STEPHENA M, CHAMP M M, CLORAN S J, et al. Die-tary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health[J]. Nutr Res Rev, 2017, 30(2):149-190.
[39] MA W, NGUYEN L H, SONG M, et al. Intake of dietary fiber, fruits, and vegetables and risk of diverticulitis[J]. Am J Gastroenterol, 2019, 114(9):1531-1538.
[40] DAHL C, CRICHTON M, JENKINS J, et al. Evidence for dietary fibre modification in the recovery and prevention of reoccurrence of acute, uncomplicated diverticulitis: a systematic literature review[J]. Nutrients, 2018, 10(2):137.
[41] HANNA M H, KAISER A M. Update on the management of sigmoid diverticulitis[J]. World J Gastroenterol, 2021, 27(9):760-781.
[42] GREGERSEN R, ANDRESEN K, BURCHARTH J, et al. Short‐term mortality, readmission, and recurrence in treatment of acute diverticulitis with abscess formation: a nationwide register‐based cohort study[J]. Int J Colorectal Dis, 2016, 31(5):983-990.
[43] HUPFELD L, BURCHARTH J, POMMERGAARD H C, et al. Risk factors for recurrence after acute colonic diverticulitis: a systematic review[J]. Int J Colorectal Dis, 2017, 32(5):611-622.
[44] GREGERSEN R, ANDRESEN K, BURCHARTH J, et al. Long‐term mortality and recurrence in patients treated for colonic diverticulitis with abscess formation: a nationwide register‐ based cohort study[J]. Int J Colorectal Dis, 2018, 33(4):431-440.
[45] GALETIN T, GALETIN A, VESTWEBER K H, et al. Systematic review and comparison of national and international guidelines on diverticular disease[J]. Int J Colorectal Dis, 2018, 33(3):261-272.
[46] National Guideline Centre (UK). Evidence review for management of recurrent acute diverticulitis: diverticular disease: diagnosis and management: evidence review P[J]. London:National Institute for Health and Care Excellence (NICE), 2019.
[47] SALLINEN V J, MENTULA P J, LEPPANIEMI A K. Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients[J]. Dis Colon Rectum, 2014, 57(7):875-881.
[48] CIROCCHI R, FEARNHEAD N, VETTORETTO N, et al. The role of emergency laparoscopic colectomy for complicated sigmoid diverticulits: a systematic review and meta‐analysis[J]. Surgeon, 2019, 17(6):360-369.
Options
Outlines

/

〈 〉