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1. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Author

Schultz, J.K. (J. K.), Azhar, N. (N.), Binda, G.A. (G. A.), Barbara, G. (G.), Biondo, S. (S.), Boermester, M.A. (M. A.), Chabok, A. (A.), Consten, E.C. (Esther), Dijk, S.M. (Sven) van, Johanssen, A. (A.), Kruis, W. (W.), Lambrichts, D.P.V. (Daniël), Post, S. (S.), Ris, F. (F.), Rockall, T.A. (T. A.), Samuelsson, A. (A.), Di Saverio, S. (Salomone), Tartaglia, D. (D.), Thorisson, A. (A.), Winter, D.C. (D. C.), Bemelman, W.A., Angenete, E. (E.), Schultz, J.K. (J. K.), Azhar, N. (N.), Binda, G.A. (G. A.), Barbara, G. (G.), Biondo, S. (S.), Boermester, M.A. (M. A.), Chabok, A. (A.), Consten, E.C. (Esther), Dijk, S.M. (Sven) van, Johanssen, A. (A.), Kruis, W. (W.), Lambrichts, D.P.V. (Daniël), Post, S. (S.), Ris, F. (F.), Rockall, T.A. (T. A.), Samuelsson, A. (A.), Di Saverio, S. (Salomone), Tartaglia, D. (D.), Thorisson, A. (A.), Winter, D.C. (D. C.), Bemelman, W.A., and Angenete, E. (E.)

Abstract

Aim: The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods: The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than 90% agreement was considered a consensus. The final phrasing of the statements with < 90% agreement was discussed in a consensus meeting at the ESCP annual meeting in Vienna in September 2019. Thereafter, the first and the last author drafted the final text of the guideline and circulated it for final approval and for a third and final online voting of rephrased statements. Results: This guideline contains 38 evidence based consensus statements on the management of diverticular disease. Conclusion: This international, multidisciplinary guideline provides an up to date summary of the current knowledge of the management of diverticular disease as a guidance for clinicians and patients.

Published
2020
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2. OC.08.3 THE “DICA” ENDOSCOPIC CLASSIFICATION FOR DIVERTICULAR DISEASE OF THE COLON SHOWS A SIGNIFICANT INTEROBSERVER AGREEMENT AMONG COMMUNITY ENDOSCOPISTS: AN INTERNATIONAL STUDY

Author

Tursi, A., primary, Brandimarte, G., additional, Di Mario, F., additional, Lanas, A., additional, Scarpignato, C., additional, Bafutto, M., additional, Barbara, G., additional, Bassotti, G., additional, Binda, G.A., additional, Biondi, A., additional, Biondo, S., additional, Cambiè, G., additional, Cassieri, C., additional, Crucitti, A., additional, Dumitrascu, D., additional, Elisei, W., additional, Escalante, R., additional, Herszènyi, L., additional, Kruis, W., additional, Kupcinskas, J., additional, Lahat, A., additional, Lecca, P.G., additional, Maconi, G., additional, Malfertheiner, P., additional, Mazzari, A., additional, Mearìn, F., additional, Milosavljevic, T., additional, Nardone, G., additional, Chavez De Oliveira, E., additional, Papa, A., additional, Papagrigoriadis, S., additional, Pera, M., additional, Persiani, R., additional, Picchio, M., additional, Regula, J., additional, Štimac, D., additional, Stollman, N., additional, Strate, L., additional, Violi, A., additional, and Walker, M., additional

Published
2020
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5. A historical review of surgery for peritonitis secondary to acute colonic diverticulitis: From Lockhart-Mummery to evidence-based medicine

Author

Cirocchi, R. Afshar, S. Di Saverio, S. Popivanov, G. De Sol, A. Gubbiotti, F. Tugnoli, G. Sartelli, M. Catena, F. Cavaliere, D. Taboła, R. Fingerhut, A. Binda, G.A.

Abstract

The management of patients with colonic diverticular perforation is still evolving. Initial lavage with or without simple suture and drainage was suggested in the late 19th century, replaced progressively by the three-stage Mayo Clinic or the two-stage Mickulicz procedures. Fears of inadequate source control prompted the implementation of the resection of the affected segment of colon with formation of a colostomy (Hartman procedure) in the 1970's. Ensuing development of the treatment strategies was driven by the recognition of the high morbidity and mortality and low reversal rates associated with the Hartman procedure. This led to the wider use of resection and primary anastomosis during the 1990's. The technique of lavage and drainage regained popularity during the 1990's. This procedure can also be performed laparoscopically with the advantage of faster recovery and shorter hospital stay. This strategy allows resectional surgery to be postponed or avoided altogether in many patients; and higher rates of primary resection and anastomosis can be achieved avoiding the need for a stoma. The three recent randomized controlled trials comparing laparoscopic peritoneal lavage alone to resectional surgery reported inconsistent outcomes. The aim of this review is to review the historical evolution and future reflections of surgical treatment modalities for diffuse purulent and feculent peritonitis. In this review we classified the various surgical strategies according to Krukowski et al. and Vermeulen et al. and reviewed the literature related to surgical treatment separately for each period. © 2017 The Author(s).

Published
2017

7. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Author

Najia Azhar, Timothy Rockall, S. T. van Dijk, M A Boermester, Giovanni Barbara, J K Schultz, Sebastiano Biondo, Stefan Post, A Samuelsson, A Johanssen, Wolfgang Kruis, Eva Angenete, Gian Andrea Binda, Abbas Chabok, A Thorisson, Esther C. J. Consten, Dario Tartaglia, Des C. Winter, Daniël P. V. Lambrichts, Frédéric Ris, S. Di Saverio, W. A. Bemelman, Schultz J.K., Azhar N., Binda G.A., Barbara G., Biondo S., Boermeester M.A., Chabok A., Consten E.C.J., van Dijk S.T., Johanssen A., Kruis W., Lambrichts D., Post S., Ris F., Rockall T.A., Samuelsson A., Di Saverio S., Tartaglia D., Thorisson A., Winter D.C., Bemelman W., Angenete E., Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and ​Robotics and image-guided minimally-invasive surgery (ROBOTICS)

Subjects
INFERIOR MESENTERIC-ARTERY, Evidence-based practice, Consensus, ACUTE PERFORATED DIVERTICULITIS, Colon, media_common.quotation_subject, diverticular disease, MEDLINE, COLORECTAL ANASTOMOTIC LEAKAGE, Online voting, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, COLOVESICAL FISTULA, Voting, Medicine, RANDOMIZED-CLINICAL-TRIAL, Humans, COMPUTED-TOMOGRAPHY, Colonic diseases, Research question, media_common, Diverticular Diseases, Medical education, ddc:617, business.industry, UNCOMPLICATED DIVERTICULITIS, Gastroenterology, Guideline, LAPAROSCOPIC SIGMOID RESECTION, Malalties del còlon, Diverticular disease, 030211 gastroenterology & hepatology, SUPERIOR RECTAL ARTERY, MODIFIED NEFF CLASSIFICATION, business, Working group
Abstract

Aim: The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods: The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than90% agreement was considered a consensus. The final phrasing of the statements with

Published
2020

8. The DICA Endoscopic Classification for Diverticular Disease of the Colon Shows a Significant Interobserver Agreement among Community Endoscopists: an International Study

Author

Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G. A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D. L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P. G., Maconi G., Malfertheiner P., Mazzarri A., Mearin F., Milosavljevic T., Nardone G., de Oliveira E. C., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L. L., Walker M. M. D., Allegretta L., Altavilla N., Amaro P., Annunziata M. L., Barberio F., Basile G., Bedogni G., Belfiori V., Benvenuti S., Bertolami C., Bisello M., El Dammak M. B., Bozzi R., Buono M., Cambie G., Capezzuto E., Casamassima C., Chavoushian A., Ciofani R., Citarella C., Compare D., Cotruta B., D'amico F., Dulk M. D., Dyrda B. E., Festa V., Gallina S., Grasso R., Hanzel J., Taieb J. M., Lai M. A., Latella G., Lisi D., Lodi L., Marangi S., Mardegan A., Marlicz W., Maurano A., Milazzo G., Militaru V., Miraglia S., Monica F., Moskalev A., Natale A., Nicolas C., Pancetti A., Penna A., Pepe A. S., Pisano M., Pontone S., Prati M., Prisco A., Rando L., Hernandez E. R., Rosati O., Rossi G., Passoni G. R., Papa V., Nesme N. S., Schiffino L., Schillaci D., Selvaggi G., Taborchi F., Tornar A., Trebuna F., Triggiani C., Testai F. V., Vassallo R., Violi A., Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, A., Biondo, S., Cassieri, C., Crucitti, A., Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzarri, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, A., Papagrigoriadis, S., Pera, M., Persiani, R., Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Walker, M. M. D., Allegretta, L., Altavilla, N., Amaro, P., Annunziata, M. L., Barberio, F., Basile, G., Bedogni, G., Belfiori, V., Benvenuti, S., Bertolami, C., Bisello, M., El Dammak, M. B., Bozzi, R., Buono, M., Cambie, G., Capezzuto, E., Casamassima, C., Chavoushian, A., Ciofani, R., Citarella, C., Compare, D., Cotruta, B., D'Amico, F., Dulk, M. D., Dyrda, B. E., Festa, V., Gallina, S., Grasso, R., Hanzel, J., Taieb, J. M., Lai, M. A., Latella, G., Lisi, D., Lodi, L., Marangi, S., Mardegan, A., Marlicz, W., Maurano, A., Milazzo, G., Militaru, V., Miraglia, S., Monica, F., Moskalev, A., Natale, A., Nicolas, C., Pancetti, A., Penna, A., Pepe, A. S., Pisano, M., Pontone, S., Prati, M., Prisco, A., Rando, L., Hernandez, E. R., Rosati, O., Rossi, G., Passoni, G. R., Papa, V., Nesme, N. S., Schiffino, L., Schillaci, D., Selvaggi, G., Taborchi, F., Tornar, A., Trebuna, F., Triggiani, C., Testai, F. V., Vassallo, R., Violi, A., Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G.A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D.L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P.G., Maconi G., Malfertheiner P., Mazzari A., Mearin F., Milosavljevic T., Nardone G., Chavez De Oliveira E., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L.L., and Walker M.M.

Subjects
BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, Diverticular Disease, Endoscopic classification, Video Recording, Colonoscopy, Gastroenterology, Severity of Illness Index, endoscopic classification, Diverticulum, classification, complications, Diverticular diseases, Endoscopy, methods, Colonic Diseases, 0302 clinical medicine, Community Health Services, Community Health Service, Observer Variation, 0303 health sciences, medicine.diagnostic_test, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, agreement − colonoscopy − community setting − diverticular disease of the colon− endoscopic classification, 3. Good health, Diverticulosis, Malalties del còlon, Diverticular disease of the colon, Diverticular disease, 616.344-007.64 [udc], Community setting, 030211 gastroenterology & hepatology, Human, medicine.medical_specialty, Scoring system, Colonic Disease, Settore MED/12 - GASTROENTEROLOGIA, Reproducibility of Result, agreement, colonoscopy, community setting, diverticular disease of the colon, Agreement, 03 medical and health sciences, Internal medicine, Severity of illness, medicine, Diverticulosis, Colonic, Humans, Colonic diseases, 030304 developmental biology, Diverticular Diseases, business.industry, Colonoscòpia, Reproducibility of Results, medicine.disease, Inter-rater reliability, business, Kappa
Abstract

Background and Aims: The Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification of diverticulosis and diverticular disease (DD) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement on this classification in an international endoscopists community setting. Methods: A total of 96 doctors (82.9% endoscopists) independently scored a set of DD endoscopic videos. The percentages of overall agreement on DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of interrater agreement. Results: Overall agreement in using DICA was 91.8% with a free-marginal kappa of 88% (95% CI 80-95). The overall agreement levels were: DICA 1, 85.2%; DICA 2, 96.5%; DICA 3, 99.5%. The free marginal κ was: DICA 1 = 0.753, DICA 2 = 0.958, DICA 3 = 0.919. The agreement about the main endoscopic items was 83.4% (k 67%) for diverticular extension, 62.6% (k 65%) for number of diverticula for each district, 86.8% (k 82%) for presence of inflammation, and 98.5 (k 98%) for presence of complications. Conclusions: The overall interrater agreement in this study ranges from good to very good. DICA score is a simple and reproducible endoscopic scoring system for diverticulosis and DD.

Published
2019

9. International consensus on diverticulosis and diverticular disease. Statements from the 3rd international symposium on diverticular disease

Author

Marjorie M. Walker, László Herszényi, Giovanni Barbara, Gabrio Bassotti, Wolfgang Kruis, Angel Lanas, G. Cambiè, Enio Chavez De Oliveira, Andrea Mazzari, A. Violi, Jaroslaw Regula, Giovanni Brandimarte, Roberto Persiani, Walter Elisei, Miguel Pera, Marcello Picchio, Sebastiano Biondo, Fermín Mearin, Claudio Cassieri, Juozas Kupcinskas, Savvas Papagrigoriadis, Antonio Tursi, Giovanni Maconi, Davor Štimac, Antonio Crucitti, Ricardo Escalante, Neil Stollman, Lisa L. Strate, P.G. Lecca, M. Bafutto, Gerardo Nardone, Tomica Milosavljeviċ, Carmelo Scarpignato, Alfredo Papa, Francesco Di Mario, Alberto Biondi, Gian Andrea Binda, Dan L. Dumitrascu, Adi Lahat, Peter Malfertheiner, Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G.A., Biondi A., Biondo S., Cambie G., Cassieri C., Crucitti A., Dumitrascu D.L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P.G., Maconi G., Malfertheiner P., Mazzari A., Mearin F., Milosavljevic T., Nardone G., de Oliveira E.C., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L.L., Violi A., Walker M.M.D., Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, A., Biondo, S., Cambie, G., Cassieri, C., Crucitti, A., Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzari, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, A., Papagrigoriadis, S., Pera, M., Persiani, R., Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Violi, A., and Walker, M. M. D.

Subjects
BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, Medical therapy, Etiology, Disease, 0302 clinical medicine, Voting, Diagnosis, Medicine, Disease management (health), Diverticuliti, health care economics and organizations, media_common, Diverticulosis, Evidence-Based Medicine, Diverticulosi, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, Gastroenterology, Consensus, Diverticular disease, Diverticulitis, Surgical therapy, 3. Good health, Malalties inflamatòries intestinals, Hot topics, 030220 oncology & carcinogenesis, Etiologia, 030211 gastroenterology & hepatology, Diagnosi, medicine.medical_specialty, Settore MED/12 - GASTROENTEROLOGIA, media_common.quotation_subject, education, MEDLINE, Consensu, Therapeutics, Inflammatory bowel diseases, diverticulosis – diverticular disease – diverticulitis – consensus – diagnosis – medical therapy – surgical therapy, 03 medical and health sciences, Humans, Diverticular Diseases, business.industry, Evidence-based medicine, Congresses as Topic, medicine.disease, Terapèutica, Diverticulum, Family medicine, business
Abstract

The statements produced by the Chairmen and Speakers of the 3rd International Symposium on Diverticular Disease, held in Madrid on April 11th-13th 2019, are reported. Topics such as current and evolving concepts on the pathogenesis, the course of the disease, the news in diagnosing, hot topics in medical and surgical treatments, and finally, critical issues on the disease were reviewed by the Chairmen who proposed 39 statements graded according to level of evidence and strength of recommendation. Each topic was explored focusing on the more relevant clinical questions. The vote was conducted on a 6-point scale and consensus was defined a priori as 67% agreement of the participants. The voting group consisted of 124 physicians from 18 countries, and agreement with all statements was provided. Comments were added explaining some controversial areas.

Published
2019

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