Journal Review in Colorectal Surgery: Diverticulitis

Behind The Knife: The Surgery Podcast

Medicine, Health & Fitness, Education, Science

4.8 • 1.4K Ratings

🗓️ 4 November 2024

⏱️ 32 minutes

🔗️ Recording | iTunes | RSS

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Summary

You have a patient with another episode of acute uncomplicated diverticulitis. This is the third episode. Do they need antibiotics? Is surgery the next step? What is their risk of recurrence with or without surgery? Tune in to find out!

Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Jason Hall MD, MPH as they discuss high yield papers discussing diverticulitis.

Learning Objectives:
1. Describe the impact on quality of life for patients who undergo surgery or non-operative management of diverticulitis
2. Discuss the indications for surgery in patients with diverticulitis
3. Describe ongoing clinical trials in management of diverticulitis

**Video Link: https://app.behindtheknife.org/video/journal-review-in-colorectal-surgery-diverticulitis

References:
Santos A, Mentula P, Pinta T, et al. Quality-of-Life and Recurrence Outcomes Following Laparoscopic Elective Sigmoid Resection vs Conservative Treatment Following Diverticulitis: Prespecified 2-Year Analysis of the LASER Randomized Clinical Trial. JAMA Surg. 2023;158(6):593–601. doi:10.1001/jamasurg.2023.0466
https://pubmed.ncbi.nlm.nih.gov/37074706/

Bolkenstein HE, Consten ECJ, van der Palen J, van de Wall BJM, Broeders IAMJ, Bemelman WA, Lange JF, Boermeester MA, Draaisma WA; Dutch Diverticular Disease (3D) Collaborative Study Group. Long-term Outcome of Surgery Versus Conservative Management for Recurrent and Ongoing Complaints After an Episode of Diverticulitis: 5-year Follow-up Results of a Multicenter Randomized Controlled Trial (DIRECT-Trial). Ann Surg. 2019 Apr;269(4):612-620. doi: 10.1097/SLA.0000000000003033. PMID: 30247329.
https://pubmed.ncbi.nlm.nih.gov/30247329/

Hall J, Hardiman K, Lee S, Lightner A, Stocchi L, Paquette IM, Steele SR, Feingold DL; Prepared on behalf of the Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Left-Sided Colonic Diverticulitis. Dis Colon Rectum. 2020 Jun;63(6):728-747. doi: 10.1097/DCR.0000000000001679. PMID: 32384404.
https://pubmed.ncbi.nlm.nih.gov/32384404/

Hall JF, Roberts PL, Ricciardi R, Read T, Scheirey C, Wald C, Marcello PW, Schoetz DJ. Long-term follow-up after an initial episode of diverticulitis: what are the predictors of recurrence? Dis Colon Rectum. 2011 Mar;54(3):283-8. doi: 10.1007/DCR.0b013e3182028576. PMID: 21304297.
https://pubmed.ncbi.nlm.nih.gov/21304297/

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Transcript

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0:00.0	Behind the Knife, The Surgery Podcast, relevant and engaging content designed to help you dominate the day. Hello, behind the knife listeners. We are very excited to be back with you for another
0:27.2	journal club in colon and rectal surgery on diverticulitis with the Leahy colorectal surgery team.
0:33.8	As always, we have another very, very special guest who's going to be joining us today,
0:37.9	and I'm going to introduce them shortly.
0:40.9	So today we're going to talk about some articles central to the discussion on the management
0:45.2	of diverticulitis.
0:46.8	And so there are lots of different aspects of diverticolitis management that we thought about
0:51.1	tackling.
0:51.9	But the articles that we're going to focus on today really
0:54.2	lay the groundwork for the ongoing Cosmit trial, which stands for the comparison of surgery
0:59.7	and medicine on the impact of diverticulitis. And this trial is currently ongoing, and it's a
1:05.1	randomized superiority trial of elective collectomy versus best medical management for patients
1:10.6	with quality of life limiting diverticular
1:13.7	disease. And we are actually one of the sites enrolling patients as are many centers around the
1:18.5	country. So today we're going to dive into the topic of surgery for diverticulitis. Is it better
1:24.4	the medical management? So welcome to the team to Dr. Peter West Marcello and Dr. Tess
1:30.1	Hannah Alette. Well, hey guys, it's great to be back together. It seems like a long time.
1:36.3	Tell us, I haven't spoken to you. So it's about 3 a.m. I think it was last week. Oh, boy.
1:41.9	There's a little call. I hope. I had a great. I think it was the last week at it. Oh, boy. Yeah. There we go.
1:45.1	Very good.
1:48.9	I had a great summer.
1:53.3	We spent time with Bianca out in the Portland coast, which was awesome.
	...

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