Répertoire de l'Université Alfonso X el Sabio

Management of acute diverticulitis with pericolic free gas (ADIFAS): an international multicenter observational study

Afficher la notice abrégée

APA

Estaire Gómez, Mercedes & Tejedor, Patricia & Pastor, Carlos & Pellino, Gianluca & Di Saverio, Salomone & Gorter-Stam, Marguerite & Sylla, Patricia & Francis, Nader & Collaborative Study Group (2023-04 ) .Management of acute diverticulitis with pericolic free gas (ADIFAS): an international multicenter observational study.

ISO 690

Estaire Gómez, Mercedes & Tejedor, Patricia & Pastor, Carlos & Pellino, Gianluca & Di Saverio, Salomone & Gorter-Stam, Marguerite & Sylla, Patricia & Francis, Nader & Collaborative Study Group. 2023-04 .Management of acute diverticulitis with pericolic free gas (ADIFAS): an international multicenter observational study.

https://hdl.handle.net/20.500.12080/39621
dc.contributor.author Estaire Gómez, Mercedes
dc.contributor.author Tejedor, Patricia
dc.contributor.author Pastor, Carlos
dc.contributor.author Pellino, Gianluca
dc.contributor.author Di Saverio, Salomone
dc.contributor.author Gorter-Stam, Marguerite
dc.contributor.author Sylla, Patricia
dc.contributor.author Francis, Nader
dc.contributor.author Collaborative Study Group
dc.date.accessioned 2024-02-09T08:31:42Z
dc.date.available 2024-02-09T08:31:42Z
dc.date.created 2023-04
dc.date.issued 2023-04
dc.identifier.uri https://hdl.handle.net/20.500.12080/39621
dc.description.abstract Background: There are no specific recommendations regarding the optimal management of this group of patients. The World Society of Emergency Surgery suggested a nonoperative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or without pericolic fluid. Methods: A multicenter, prospective, international study of patients diagnosed with AD and pericolic-free air with or without pericolic free fluid at a computed tomography (CT) scan between May 2020 and June 2021 was included. Patients were excluded if they had intra abdominal distant free air, an abscess, generalized peritonitis, or less than a 1-year follow-up. The primary outcome was the rate of failure of nonoperative management within the index admission. Secondary outcomes included the rate of failure of nonoperative management within the first year and risk factors for failure. Results: A total of 810 patients were recruited across 69 European and South American centers; 744 patients (92%) were treated nonoperatively, and 66 (8%) underwent immediate surgery. Baseline characteristics were similar between groups. Hinchey II¿IV on diagnostic imaging was the only independent risk factor for surgical intervention during index admission (odds ratios: 12.5, 95% CI: 2.4¿64, P=0.003). Among patients treated nonoperatively, at index admission, 697 (94%) patients were discharged without any complications, 35 (4.7%) required emergency surgery, and 12 (1.6%) percutaneous drainage. Free pericolic fluid on CT scan was associated with a higher risk of failure of nonoperative management (odds ratios: 4.9, 95% CI: 1.2¿19.9, P=0.023), with 88% of success compared to 96% without free fluid (P<0.001). The rate of treatment failure with nonoperative management during the first year of follow up was 16.5%. Conclusion: Patients with AD presenting with pericolic free gas can be successfully managed nonoperatively in the vast majority of cases. Patients with both free pericolic gas and free pericolic fluid on a CT scan are at a higher risk of failing nonoperative management and require closer observation. Keywords: complication, diverticular disease, diverticulitis, diverticulosis, nonoperative management es_ES
dc.format application/pdf es_ES
dc.language eng es_ES
dc.rights CC-BY es_ES
dc.rights.uri http://creativecommons.org/licenses/by/4.0/deed.es es_ES
dc.title Management of acute diverticulitis with pericolic free gas (ADIFAS): an international multicenter observational study es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.rights.accessrights info:eu-repo/semantics/openAccess es_ES
dc.identifier.location N/A es_ES


Fichier(s) constituant ce document

Ce document figure dans la(les) collection(s) suivante(s)

Afficher la notice abrégée

CC-BY Excepté là où spécifié autrement, la license de ce document est décrite en tant que CC-BY

Chercher dans le dépôt


Parcourir

Mon compte

Social Media