World Journal of Emergency Surgery (Jan 2022)
The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly
- Paola Fugazzola,
- Marco Ceresoli,
- Federico Coccolini,
- Francesco Gabrielli,
- Alessandro Puzziello,
- Fabio Monzani,
- Bruno Amato,
- Gabriele Sganga,
- Massimo Sartelli,
- Francesco Menichetti,
- Gabriele Adolfo Puglisi,
- Dario Tartaglia,
- Paolo Carcoforo,
- Nicola Avenia,
- Yoram Kluger,
- Ciro Paolillo,
- Mauro Zago,
- Ari Leppäniemi,
- Matteo Tomasoni,
- Lorenzo Cobianchi,
- Francesca Dal Mas,
- Mario Improta,
- Ernest E. Moore,
- Andrew B. Peitzman,
- Michael Sugrue,
- Vanni Agnoletti,
- Gustavo P. Fraga,
- Dieter G. Weber,
- Dimitrios Damaskos,
- Fikri M. Abu-Zidan,
- Imtiaz Wani,
- Andrew W. Kirkpatrick,
- Manos Pikoulis,
- Nikolaos Pararas,
- Edward Tan,
- Richard Ten Broek,
- Ronald V. Maier,
- R. Justin Davies,
- Jeffry Kashuk,
- Vishal G. Shelat,
- Alain Chicom Mefire,
- Goran Augustin,
- Stefano Magnone,
- Elia Poiasina,
- Belinda De Simone,
- Massimo Chiarugi,
- Walt Biffl,
- Gian Luca Baiocchi,
- Fausto Catena,
- Luca Ansaloni
Affiliations
- Paola Fugazzola
- IRCCS Policlinico San Matteo Foundation, General Surgery
- Marco Ceresoli
- General Surgery Department, School of Medicine and Surgery, Milano-Bicocca University
- Federico Coccolini
- Emergency Surgery Unit, State University of Pisa, Cisanello Hospital
- Francesco Gabrielli
- General Surgery Department, School of Medicine and Surgery, Milano-Bicocca University
- Alessandro Puzziello
- Department of Surgery and Transplants, AOU San Giovanni di Dio and Ruggi d’Aragona, University of Salerno
- Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa
- Bruno Amato
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”
- Gabriele Sganga
- Emergency Surgery and Trauma, Fondazione Policlinico Universitario “A. Gemelli” IRCCS
- Massimo Sartelli
- Department of Surgery, Macerata Hospital
- Francesco Menichetti
- Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Pisa
- Gabriele Adolfo Puglisi
- Emergency Surgery Unit, State University of Pisa, Cisanello Hospital
- Dario Tartaglia
- Emergency Surgery Unit, State University of Pisa, Cisanello Hospital
- Paolo Carcoforo
- Department of Surgery, S. Anna University Hospital and University of Ferrara
- Nicola Avenia
- Medical School, General Surgery and Surgical Specialties Unit, S. Maria University Hospital University of Perugia
- Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus
- Ciro Paolillo
- Emergency Room Brescia Spedali Civili General Hospital
- Mauro Zago
- Department of Robotic and Emergency Surgery, Manzoni Hospital, ASST Lecco
- Ari Leppäniemi
- Abdominal Center, Helsinki University Hospital and University of Helsinki
- Matteo Tomasoni
- IRCCS Policlinico San Matteo Foundation, General Surgery
- Lorenzo Cobianchi
- IRCCS Policlinico San Matteo Foundation, General Surgery
- Francesca Dal Mas
- Department of Management, Lincoln International Business School, University of Lincoln
- Mario Improta
- Alma Mater Studiorum University
- Ernest E. Moore
- Department of Surgery, University of Colorado, Denver Health Medical Center
- Andrew B. Peitzman
- Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian
- Michael Sugrue
- Donegal Clinical Research Academy, Emergency Surgery Outcome Project, Letterkenny University Hospital
- Vanni Agnoletti
- Intensive Care Unit, Bufalini Hospital
- Gustavo P. Fraga
- Surgery Department, Faculdade de Ciências Médicas (FCM), Unicamp Campinas
- Dieter G. Weber
- Department of General Surgery, Royal Perth Hospital
- Dimitrios Damaskos
- Department of Surgery, Royal Infirmary of Edinburgh
- Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University
- Imtiaz Wani
- Department of Minimal Access and General Surgery, Government Gousia Hospital
- Andrew W. Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre
- Manos Pikoulis
- 3Rd Department of Surgery, Attiko Hospital, MSc “Global Health-Disaster Medicine”, National and Kapodistrian University of Athens (NKUA)
- Nikolaos Pararas
- General Surgery, Dr Sulaiman Al Habib/Alfaisal University
- Edward Tan
- Department of Surgery, Radboud University Medical Centre
- Richard Ten Broek
- Department of Surgery, Radboud University Medical Centre
- Ronald V. Maier
- Department of Surgery, University of Washington
- R. Justin Davies
- Cambridge Colorectal Unit, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust
- Jeffry Kashuk
- Department of Surgery, Assia Medical Group, Tel Aviv University Sackler School of Medicine
- Vishal G. Shelat
- Department of General Surgery, Tan Tock Seng Hospital
- Alain Chicom Mefire
- Faculty of Health Sciences, University of Buea
- Goran Augustin
- Department of Surgery, University Hospital Centre
- Stefano Magnone
- General Surgery I, ASST Papa Giovanni XXIII Hospital
- Elia Poiasina
- General Surgery I, ASST Papa Giovanni XXIII Hospital
- Belinda De Simone
- Department of General and Metabolic Surgery, Poissy and Saint Germain en Laye Hospitals
- Massimo Chiarugi
- Emergency Surgery Unit, State University of Pisa, Cisanello Hospital
- Walt Biffl
- Trauma Surgery Department, Scripps Memorial Hospital
- Gian Luca Baiocchi
- Department of General Surgery, ASST Cremona, University of Brescia
- Fausto Catena
- General and Emergency Surgery Department, Bufalini Hospital, AUSL Romagna
- Luca Ansaloni
- IRCCS Policlinico San Matteo Foundation, General Surgery
- DOI
- https://doi.org/10.1186/s13017-022-00408-0
- Journal volume & issue
-
Vol. 17,
no. 1
pp. 1 – 16
Abstract
Abstract 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.
Keywords
