The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly,World Journal of Emergency Surgery

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The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly
World Journal of Emergency Surgery ( IF 6.0 ) Pub Date : 2022-01-21 , DOI: 10.1186/s13017-022-00408-0
Paola Fugazzola ₁ , Marco Ceresoli ₂ , Federico Coccolini ₃ , Francesco Gabrielli ₂ , Alessandro Puzziello ₄ , Fabio Monzani ₅ , Bruno Amato ₆ , Gabriele Sganga ₇ , Massimo Sartelli ₈ , Francesco Menichetti ₉ , Gabriele Adolfo Puglisi ₃ , Dario Tartaglia ₃ , Paolo Carcoforo ₁₀ , Nicola Avenia ₁₁ , Yoram Kluger ₁₂ , Ciro Paolillo ₁₃ , Mauro Zago ₁₄ , Ari Leppäniemi ₁₅ , Matteo Tomasoni ₁ , Lorenzo Cobianchi ₁ , Francesca Dal Mas ₁₆ , Mario Improta ₁₇ , Ernest E Moore ₁₈ , Andrew B Peitzman ₁₉ , Michael Sugrue ₂₀ , Vanni Agnoletti ₂₁ , Gustavo P Fraga ₂₂ , Dieter G Weber ₂₃ , Dimitrios Damaskos ₂₄ , Fikri M Abu-Zidan ₂₅ , Imtiaz Wani ₂₆ , Andrew W Kirkpatrick ₂₇ , Manos Pikoulis ₂₈ , Nikolaos Pararas ₂₉ , Edward Tan ₃₀ , Richard Ten Broek ₃₀ , Ronald V Maier ₃₁ , R Justin Davies ₃₂ , Jeffry Kashuk ₃₃ , Vishal G Shelat ₃₄ , Alain Chicom Mefire ₃₅ , Goran Augustin ₃₆ , Stefano Magnone ₃₇ , Elia Poiasina ₃₇ , Belinda De Simone ₃₈ , Massimo Chiarugi ₃ , Walt Biffl ₃₉ , Gian Luca Baiocchi ₄₀ , Fausto Catena ₄₁ , Luca Ansaloni ₁

Affiliation

IRCCS Policlinico San Matteo Foundation, General Surgery, Pavia, Italy.
General Surgery Department, School of Medicine and Surgery, Milano-Bicocca University, Monza, Italy.
Emergency Surgery Unit, State University of Pisa, Cisanello Hospital, Pisa, Italy.
Department of Surgery and Transplants, AOU San Giovanni di Dio and Ruggi d'Aragona, University of Salerno, Fisciano, Italy.
Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
Emergency Surgery and Trauma, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Department of Surgery, Macerata Hospital, Macerata, Italy.
Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Department of Surgery, S. Anna University Hospital and University of Ferrara, Ferrara, Italy.
Medical School, General Surgery and Surgical Specialties Unit, S. Maria University Hospital University of Perugia, Terni, Italy.
Division of General Surgery, Rambam Health Care Campus, Haifa, Israel.
Emergency Room Brescia Spedali Civili General Hospital, Brescia, Italy.
Department of Robotic and Emergency Surgery, Manzoni Hospital, ASST Lecco, Lecco, Italy.
Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Department of Management, Lincoln International Business School, University of Lincoln, Lincoln, UK.
Alma Mater Studiorum University, Bologna, Italy.
Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO, USA.
Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, PA, USA.
Donegal Clinical Research Academy, Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland.
Intensive Care Unit, Bufalini Hospital, Cesena, Italy.
Surgery Department, Faculdade de Ciências Médicas (FCM), Unicamp Campinas, Campinas, SP, Brazil.
Department of General Surgery, Royal Perth Hospital, Perth, Australia.
Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
Department of Minimal Access and General Surgery, Government Gousia Hospital, Sringar, Kashmir, India.
General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB, Canada.
3Rd Department of Surgery, Attiko Hospital, MSc "Global Health-Disaster Medicine", National and Kapodistrian University of Athens (NKUA), Athens, Greece.
General Surgery, Dr Sulaiman Al Habib/Alfaisal University, Riyadh, Saudi Arabia.
Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
Department of Surgery, University of Washington, Seattle, WA, USA.
Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Department of Surgery, Assia Medical Group, Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel.
Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Department of Surgery, University Hospital Centre, Zagreb, Croatia.
General Surgery I, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.
Department of General and Metabolic Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France.
Trauma Surgery Department, Scripps Memorial Hospital, La Jolla, CA, USA.
Department of General Surgery, ASST Cremona, University of Brescia, Cremona, Italy.
General and Emergency Surgery Department, Bufalini Hospital, AUSL Romagna, Cesena, Italy.

Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1° Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy.

中文翻译：

WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC老年人急性左结肠憩室炎诊治指南

与年轻患者相比，老年人急性左结肠憩室炎（ALCD）具有独特的流行病学特征。老年人群的临床表现更为细微，住院和术后死亡率较高。此外，老年合并症是复杂性憩室炎的危险因素。最后，与年轻患者相比，老年患者复发的风险较低，并且在复发的情况下，需要紧急手术的可能性较低。本工作的目的是研究年龄相关因素，与 WSES 急性左侧结肠憩室炎管理指南相比，这些因素可能支持诊断和治疗老年人这一问题的独特方法。在 1° Pisa 急性护理研讨会期间创伤外科于 2019 年 9 月在比萨（意大利）举办，由世界急诊外科学会 (WSES)、意大利老年外科学会 (SICG)、意大利医院外科医生协会 (ACOI)、意大利急诊外科和创伤协会 (SICUT)、急诊医学和护理学院 (AcEMC) 和意大利外科病理生理学会 (SIFIPAC)，三位专家组成员分别针对 ALCD 诊断和管理的四个主题分别发表了一些声明在专家小组参加的共识会议上，根据 GRADE 方法制定的老年患者。这些声明随后经过辩论、修订并最终得到共识会议与会者的批准。

更新日期：2022-01-21

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