EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice

Nader K. Francis; Patricia Sylla; Maria Abou-Khalil; Simone Arolfo; David Berler; Nathan J. Curtis; Scott C. Dolejs; Richard Garfinkle; Marguerite Gorter-Stam; Daniel A. Hashimoto; Taryn E. Hassinger; Charlotte J. L. Molenaar; Philip H. Pucher; Valerie Schuermans; Alberto Arezzo; Ferdinando Agresta; Stavros A. Antoniou; Tan Arulampalam; Marylise Boutros; Nicole Bouvy; Kenneth Campbell; Todd Francone; Stephen P. Haggerty; Traci L. Hedrick; Dimitrios Stefanidis; Mike S. Truitt; Jillian Kelly; Hans Ket; Brian J. Dunkin; Andrea Pietrabissa

doi:10.1007/s00464-019-06882-z

EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice

Nader K. Francis^*, Patricia Sylla, Maria Abou-Khalil, Simone Arolfo, David Berler, Nathan J. Curtis^*, Scott C. Dolejs, Richard Garfinkle, Marguerite Gorter-Stam, Daniel A. Hashimoto, Taryn E. Hassinger, Charlotte J. L. Molenaar, Philip H. Pucher, Valerie Schuermans, Alberto Arezzo, Ferdinando Agresta, Stavros A. Antoniou, Tan Arulampalam, Marylise Boutros, Nicole BouvyKenneth Campbell, Todd Francone, Stephen P. Haggerty, Traci L. Hedrick, Dimitrios Stefanidis, Mike S. Truitt, Jillian Kelly, Hans Ket, Brian J. Dunkin, Andrea Pietrabissa

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

72 Citations (Web of Science)

Abstract

Background Acute diverticulitis (AD) presents a unique diagnostic and therapeutic challenge for general surgeons. This collaborative project between EAES and SAGES aimed to summarize recent evidence and draw statements of recommendation to guide our members on comprehensive AD management. Methods Systematic reviews of the literature were conducted across six AD topics by an international steering group including experts from both societies. Topics encompassed the epidemiology, diagnosis, management of non-complicated and complicated AD as well as emergency and elective operative AD management. Consensus statements and recommendations were generated, and the quality of the evidence and recommendation strength rated with the GRADE system. Modified Delphi methodology was used to reach consensus among experts prior to surveying the EAES and SAGES membership on the recommendations and likelihood to impact their practice. Results were presented at both EAES and SAGES annual meetings with live re-voting carried out for recommendations with <70% agreement. Results A total of 51 consensus statements and 41 recommendations across all six topics were agreed upon by the experts and submitted for members' online voting. Based on 1004 complete surveys and over 300 live votes at the SAGES and EAES Diverticulitis Consensus Conference (DCC), consensus was achieved for 97.6% (40/41) of recommendations with 92% (38/41) agreement on the likelihood that these recommendations would change practice if not already applied. Areas of persistent disagreement included the selective use of imaging to guide AD diagnosis, recommendations against antibiotics in non-complicated AD, and routine colonic evaluation after resolution of non-complicated diverticulitis. Conclusion This joint EAES and SAGES consensus conference updates clinicians on the current evidence and provides a set of recommendations that can guide clinical AD management practice.

Original language	English
Pages (from-to)	2726-2741
Number of pages	16
Journal	Surgical endoscopy and other interventional techniques
Volume	33
Issue number	9
DOIs	https://doi.org/10.1007/s00464-019-06882-z
Publication status	Published - Sept 2019

Keywords

Diverticulitis
Acute
Elective surgery
Emergency surgery
Lavage
Consensus
Guidelines
DIAGNOSIS

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10.1007/s00464-019-06882-z

Cite this

Francis, N. K., Sylla, P., Abou-Khalil, M., Arolfo, S., Berler, D., Curtis, N. J., Dolejs, S. C., Garfinkle, R., Gorter-Stam, M., Hashimoto, D. A., Hassinger, T. E., Molenaar, C. J. L., Pucher, P. H., Schuermans, V., Arezzo, A., Agresta, F., Antoniou, S. A., Arulampalam, T., Boutros, M., ... Pietrabissa, A. (2019). EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice. Surgical endoscopy and other interventional techniques, 33(9), 2726-2741. https://doi.org/10.1007/s00464-019-06882-z

@article{57675188d0134b59a5c5dfd45f35d697,

title = "EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice",

abstract = "Background Acute diverticulitis (AD) presents a unique diagnostic and therapeutic challenge for general surgeons. This collaborative project between EAES and SAGES aimed to summarize recent evidence and draw statements of recommendation to guide our members on comprehensive AD management. Methods Systematic reviews of the literature were conducted across six AD topics by an international steering group including experts from both societies. Topics encompassed the epidemiology, diagnosis, management of non-complicated and complicated AD as well as emergency and elective operative AD management. Consensus statements and recommendations were generated, and the quality of the evidence and recommendation strength rated with the GRADE system. Modified Delphi methodology was used to reach consensus among experts prior to surveying the EAES and SAGES membership on the recommendations and likelihood to impact their practice. Results were presented at both EAES and SAGES annual meetings with live re-voting carried out for recommendations with <70% agreement. Results A total of 51 consensus statements and 41 recommendations across all six topics were agreed upon by the experts and submitted for members' online voting. Based on 1004 complete surveys and over 300 live votes at the SAGES and EAES Diverticulitis Consensus Conference (DCC), consensus was achieved for 97.6% (40/41) of recommendations with 92% (38/41) agreement on the likelihood that these recommendations would change practice if not already applied. Areas of persistent disagreement included the selective use of imaging to guide AD diagnosis, recommendations against antibiotics in non-complicated AD, and routine colonic evaluation after resolution of non-complicated diverticulitis. Conclusion This joint EAES and SAGES consensus conference updates clinicians on the current evidence and provides a set of recommendations that can guide clinical AD management practice.",

keywords = "Diverticulitis, Acute, Elective surgery, Emergency surgery, Lavage, Consensus, Guidelines, DIAGNOSIS",

author = "Francis, {Nader K.} and Patricia Sylla and Maria Abou-Khalil and Simone Arolfo and David Berler and Curtis, {Nathan J.} and Dolejs, {Scott C.} and Richard Garfinkle and Marguerite Gorter-Stam and Hashimoto, {Daniel A.} and Hassinger, {Taryn E.} and Molenaar, {Charlotte J. L.} and Pucher, {Philip H.} and Valerie Schuermans and Alberto Arezzo and Ferdinando Agresta and Antoniou, {Stavros A.} and Tan Arulampalam and Marylise Boutros and Nicole Bouvy and Kenneth Campbell and Todd Francone and Haggerty, {Stephen P.} and Hedrick, {Traci L.} and Dimitrios Stefanidis and Truitt, {Mike S.} and Jillian Kelly and Hans Ket and Dunkin, {Brian J.} and Andrea Pietrabissa",

year = "2019",

month = sep,

doi = "10.1007/s00464-019-06882-z",

language = "English",

volume = "33",

pages = "2726--2741",

journal = "Surgical endoscopy and other interventional techniques",

issn = "0930-2794",

publisher = "Springer, Cham",

number = "9",

}

Francis, NK, Sylla, P, Abou-Khalil, M, Arolfo, S, Berler, D, Curtis, NJ, Dolejs, SC, Garfinkle, R, Gorter-Stam, M, Hashimoto, DA, Hassinger, TE, Molenaar, CJL, Pucher, PH, Schuermans, V, Arezzo, A, Agresta, F, Antoniou, SA, Arulampalam, T, Boutros, M, Bouvy, N, Campbell, K, Francone, T, Haggerty, SP, Hedrick, TL, Stefanidis, D, Truitt, MS, Kelly, J, Ket, H, Dunkin, BJ & Pietrabissa, A 2019, 'EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice', Surgical endoscopy and other interventional techniques, vol. 33, no. 9, pp. 2726-2741. https://doi.org/10.1007/s00464-019-06882-z

EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice. / Francis, Nader K.; Sylla, Patricia; Abou-Khalil, Maria et al.
In: Surgical endoscopy and other interventional techniques, Vol. 33, No. 9, 09.2019, p. 2726-2741.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - EAES and SAGES 2018 consensus conference on acute diverticulitis management

T2 - evidence-based recommendations for clinical practice

AU - Francis, Nader K.

AU - Sylla, Patricia

AU - Abou-Khalil, Maria

AU - Arolfo, Simone

AU - Berler, David

AU - Curtis, Nathan J.

AU - Dolejs, Scott C.

AU - Garfinkle, Richard

AU - Gorter-Stam, Marguerite

AU - Hashimoto, Daniel A.

AU - Hassinger, Taryn E.

AU - Molenaar, Charlotte J. L.

AU - Pucher, Philip H.

AU - Schuermans, Valerie

AU - Arezzo, Alberto

AU - Agresta, Ferdinando

AU - Antoniou, Stavros A.

AU - Arulampalam, Tan

AU - Boutros, Marylise

AU - Bouvy, Nicole

AU - Campbell, Kenneth

AU - Francone, Todd

AU - Haggerty, Stephen P.

AU - Hedrick, Traci L.

AU - Stefanidis, Dimitrios

AU - Truitt, Mike S.

AU - Kelly, Jillian

AU - Ket, Hans

AU - Dunkin, Brian J.

AU - Pietrabissa, Andrea

PY - 2019/9

Y1 - 2019/9

N2 - Background Acute diverticulitis (AD) presents a unique diagnostic and therapeutic challenge for general surgeons. This collaborative project between EAES and SAGES aimed to summarize recent evidence and draw statements of recommendation to guide our members on comprehensive AD management. Methods Systematic reviews of the literature were conducted across six AD topics by an international steering group including experts from both societies. Topics encompassed the epidemiology, diagnosis, management of non-complicated and complicated AD as well as emergency and elective operative AD management. Consensus statements and recommendations were generated, and the quality of the evidence and recommendation strength rated with the GRADE system. Modified Delphi methodology was used to reach consensus among experts prior to surveying the EAES and SAGES membership on the recommendations and likelihood to impact their practice. Results were presented at both EAES and SAGES annual meetings with live re-voting carried out for recommendations with <70% agreement. Results A total of 51 consensus statements and 41 recommendations across all six topics were agreed upon by the experts and submitted for members' online voting. Based on 1004 complete surveys and over 300 live votes at the SAGES and EAES Diverticulitis Consensus Conference (DCC), consensus was achieved for 97.6% (40/41) of recommendations with 92% (38/41) agreement on the likelihood that these recommendations would change practice if not already applied. Areas of persistent disagreement included the selective use of imaging to guide AD diagnosis, recommendations against antibiotics in non-complicated AD, and routine colonic evaluation after resolution of non-complicated diverticulitis. Conclusion This joint EAES and SAGES consensus conference updates clinicians on the current evidence and provides a set of recommendations that can guide clinical AD management practice.

AB - Background Acute diverticulitis (AD) presents a unique diagnostic and therapeutic challenge for general surgeons. This collaborative project between EAES and SAGES aimed to summarize recent evidence and draw statements of recommendation to guide our members on comprehensive AD management. Methods Systematic reviews of the literature were conducted across six AD topics by an international steering group including experts from both societies. Topics encompassed the epidemiology, diagnosis, management of non-complicated and complicated AD as well as emergency and elective operative AD management. Consensus statements and recommendations were generated, and the quality of the evidence and recommendation strength rated with the GRADE system. Modified Delphi methodology was used to reach consensus among experts prior to surveying the EAES and SAGES membership on the recommendations and likelihood to impact their practice. Results were presented at both EAES and SAGES annual meetings with live re-voting carried out for recommendations with <70% agreement. Results A total of 51 consensus statements and 41 recommendations across all six topics were agreed upon by the experts and submitted for members' online voting. Based on 1004 complete surveys and over 300 live votes at the SAGES and EAES Diverticulitis Consensus Conference (DCC), consensus was achieved for 97.6% (40/41) of recommendations with 92% (38/41) agreement on the likelihood that these recommendations would change practice if not already applied. Areas of persistent disagreement included the selective use of imaging to guide AD diagnosis, recommendations against antibiotics in non-complicated AD, and routine colonic evaluation after resolution of non-complicated diverticulitis. Conclusion This joint EAES and SAGES consensus conference updates clinicians on the current evidence and provides a set of recommendations that can guide clinical AD management practice.

KW - Diverticulitis

KW - Acute

KW - Elective surgery

KW - Emergency surgery

KW - Lavage

KW - Consensus

KW - Guidelines

KW - DIAGNOSIS

U2 - 10.1007/s00464-019-06882-z

DO - 10.1007/s00464-019-06882-z

M3 - Article

SN - 0930-2794

VL - 33

SP - 2726

EP - 2741

JO - Surgical endoscopy and other interventional techniques

JF - Surgical endoscopy and other interventional techniques

IS - 9

ER -