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 (Lead / Corresponding author), Scott C. Dolejs, Richard Garfinkle, Marguerite Gorter-Stam, Daniel A. Hashimoto, Taryn E. Hassinger, Charlotte J. L. Molenaar, Philip H. Pucher, Valérie Schuermans, Alberto Arezzo, Ferdinando Agresta, Stavros A. Antoniou, Tan Arulampalam, Marylise Boutros, Nicole Bouvy & 10 others Kenneth Campbell, Todd Francone, Stephen P. Haggerty, Traci L. Hedrick, Dimitrios Stefanidis, Mike S. Truitt, Jillian Kelly, Hans Ket, Brian J. Dunkin, Andrea Pietrabissa

Research output: Contribution to journalArticle

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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 languageEnglish
Pages (from-to)2726-2741
Number of pages16
JournalSurgical Endoscopy
Volume33
Issue number9
Early online date27 Jun 2019
DOIs
Publication statusPublished - Sep 2019

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Diverticulitis
Politics
Colonic Diverticulitis
Practice Management
Epidemiology
Emergencies
Joints
Anti-Bacterial Agents

Keywords

  • Acute
  • Consensus
  • Diverticulitis
  • Elective surgery
  • Emergency surgery
  • Guidelines
  • Lavage

Cite this

Francis, N. K., Sylla, P., Abou-Khalil, M., Arolfo, S., Berler, D., Curtis, N. J., ... Pietrabissa, A. (2019). EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice. Surgical Endoscopy, 33(9), 2726-2741. https://doi.org/10.1007/s00464-019-06882-z
Francis, Nader K. ; Sylla, Patricia ; Abou-Khalil, Maria ; Arolfo, Simone ; Berler, David ; Curtis, Nathan J. ; Dolejs, Scott C. ; Garfinkle, Richard ; Gorter-Stam, Marguerite ; Hashimoto, Daniel A. ; Hassinger, Taryn E. ; Molenaar, Charlotte J. L. ; Pucher, Philip H. ; Schuermans, Valérie ; Arezzo, Alberto ; Agresta, Ferdinando ; Antoniou, Stavros A. ; Arulampalam, Tan ; Boutros, Marylise ; Bouvy, Nicole ; Campbell, Kenneth ; Francone, Todd ; Haggerty, Stephen P. ; Hedrick, Traci L. ; Stefanidis, Dimitrios ; Truitt, Mike S. ; Kelly, Jillian ; Ket, Hans ; Dunkin, Brian J. ; Pietrabissa, Andrea. / EAES and SAGES 2018 consensus conference on acute diverticulitis management : evidence-based recommendations for clinical practice. In: Surgical Endoscopy. 2019 ; Vol. 33, No. 9. pp. 2726-2741.
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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.",
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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, 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; Arolfo, Simone; Berler, David; Curtis, Nathan J. (Lead / Corresponding author); Dolejs, Scott C.; Garfinkle, Richard; Gorter-Stam, Marguerite; Hashimoto, Daniel A.; Hassinger, Taryn E.; Molenaar, Charlotte J. L.; Pucher, Philip H.; Schuermans, Valérie; Arezzo, Alberto; Agresta, Ferdinando; Antoniou, Stavros A.; Arulampalam, Tan; Boutros, Marylise; Bouvy, Nicole; Campbell, Kenneth; Francone, Todd; Haggerty, Stephen P.; Hedrick, Traci L.; Stefanidis, Dimitrios; Truitt, Mike S.; Kelly, Jillian; Ket, Hans; Dunkin, Brian J.; Pietrabissa, Andrea.

In: Surgical Endoscopy, Vol. 33, No. 9, 09.2019, p. 2726-2741.

Research output: Contribution to journalArticle

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, Valérie

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.

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KW - Consensus

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KW - Elective surgery

KW - Emergency surgery

KW - Guidelines

KW - Lavage

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