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IPOD Study: Management of Acute Left Colonic Diverticulitis in Italian Surgical Departments

2016; Springer Science+Business Media; Volume: 41; Issue: 3 Linguagem: Inglês

10.1007/s00268-016-3800-y

1432-2323

Massimo Sartelli, Gian Andrea Binda, Francesco Brandara, Andrea Borasi, Francesco Feroci, Salvatore Vadalà, Francesco M. Labricciosa, Arianna Birindelli, Gianluigi Luridiana, Federico Coccolini, Salomone Di Saverio, Fausto Catena, Luca Ansaloni, Fabio Cesare Campanile, Ferdinando Agresta, Diego Piazza, Gabriele Anania, Emanuele Caproli, Marcello Gasparrini, Pierpaolo Bordoni, Andrea Lucchi, Stefano Scabini, Biagio Picardi, Giuliano Sarro, Alice Piccinini, Natalino Bedin, Alessandro Bussotti, Renato De Angelis, Gian Luca Baiocchi, A Andreotti, Nicola Cillara, Barbara Petronio, Sergio Grimaldi, Alessia Biancafarina, Dario Somenzi, Andrea Costanzi, A. Marvaso, Alfonso Canfora, Giorgio Vasquez, Carlo Chiodo, M Nano, Angelo Cavicchi, Alberto Ruffato, Paolo Baccari, Roberto Polastri, Patrizia Marsanic, Giuseppe Portale, Luca Gordini, Hariscine K. Abongwa, Michela Pili, Luca Turati, Vittoria Nusca, Gianluca Guercioni, Leonardo Andrea Delogu, Umberto Robustelli, D. Piras, Fernando Serventi, Daniela Prando, Antonio Brunelli, Bruno Zani, Salvatore Pintaldi, Augusto Verzelli, Silvia Mulas, Gianmaria Confalonieri, Giuditta Spagni, Antonio Crucitti, Andrea Sagnotta, Stefania Fiume, Francesco Balestra, Matteo Gatti, Emilio Eugeni, Amedeo Carraro, Michele Genna, Lucio Taglietti, Antonio Azzinnaro, Stefano Ferfoglia, Giuseppe Miranda, Giuseppe Tirone, Pietro Luparello, Stefano Berti, Roberta Tutino, A De Manzoni Garberini, Francesco Roscio, Valeria Maglione, Mauro Podda, Giovanna Ioia, Fabrizio Cantore, Franco Mazzalai, Francesco Cortesi, Giacomo Arcuri, Giovanni Bellanova, Massimo Beltramo, A Chessa, M. Nicholas Coppola, Davide Gozzo, Asaf Harbi, Edoardo Minciotti, Francesco Pata, Giovanni Pinna, Mario Testini, Serafino Vanella,

Gastrointestinal disorders and treatments

Abstract Background In recent years, the emergency management of acute left colonic diverticulitis (ALCD) has evolved dramatically despite lack of strong evidence. As a consequence, management strategies are frequently guided by surgeon’s personal preference, rather than by scientific evidence. The primary aim of IPOD study (Italian Prospective Observational Diverticulitis study) is to describe both the diagnostic and treatment profiles of patients with ALCD in the Italian surgical departments. Methods IPOD study is a prospective observational study performed during a 6‐month period (from April 1 2015 to September 1 2015) and including 89 Italian surgical departments. All consecutive patients with suspected clinical diagnosis of ALCD confirmed by imaging and seen by a surgeon were included in the study. The study was promoted by the Italian Society of Hospital Surgeons and the World Society of Emergency Surgery Italian chapter. Results Eleven hundred and twenty‐five patients with a median age of 62 years [interquartile range (IQR), 51–74] were enrolled in the IPOD study. One thousand and fifty‐four (93.7%) patients were hospitalized with a median duration of hospitalization of 7 days (IQR 5–10). Eight hundred and twenty‐eight patients (73.6%) underwent medical treatment alone, 13 patients had percutaneous drainage (1.2%), and the other 284 (25.2%) patients underwent surgery as first treatment. Among 121 patients having diffuse peritonitis, 71 (58.7%) underwent Hartmann’s resection. However, the Hartmann’s resection was used even in patients with lower stages of ALCD (36/479; 7.5%) where other treatment options could be more adequate. Conclusions The IPOD study demonstrates that in the Italian surgical departments treatment strategies for ALCD are often guided by the surgeon’s personal preference.