دورية أكاديمية
Towards a tailored approach for patients with acute diverticulitis and abscess formation. The DivAbsc2023 multicentre case–control study
| العنوان: | Towards a tailored approach for patients with acute diverticulitis and abscess formation. The DivAbsc2023 multicentre case–control study |
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| المؤلفون: | Ceresoli, Marco, Ortenzi, Monica, Podda, Mauro, Di Martino, Marcello, Pellino, Gianluca, Pata, Francesco |
| المساهمون: | Institut Català de la Salut, Podda M Emergency Surgery Unit, Department of Surgical Science, University of Cagliari, Policlinico Universitario “D. Casula”, Azienda Ospedaliero-Universitaria di Cagliari, Monserrato, Italy. Ceresoli M General and Emergency Surgery Department, School of Medicine and Surgery, Milano-Bicocca University, Monza, Italy. Di Martino M Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy. Ortenzi M Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy. Pellino G Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania ‘Luigi Vanvitelli’, Naples, Italy. Pata F Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy, Vall d'Hebron Barcelona Hospital Campus |
| المصدر: | Scientia |
| بيانات النشر: | Springer |
| سنة النشر: | 2024 |
| مصطلحات موضوعية: | Avaluació de resultats (Assistència sanitària), Drenatge quirúrgic, Diverticulosi, Intestins - Malalties - Tractament, Abscessos, DISEASES::Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Diverticular Diseases::Diverticulitis::Digestive System Diseases::Gastrointestinal Diseases::Diverticulitis, Colonic, Other subheadings::Other subheadings::/therapy, DISEASES::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Drainage, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome::Treatment Failure, ENFERMEDADES::enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedades diverticulares::diverticulitis::enfermedades del sistema digestivo::enfermedades gastrointestinales::diverticulitis del colon, Otros calificadores::Otros calificadores::/terapia, ENFERMEDADES::infecciones bacterianas y micosis::infección::supuración::absceso::absceso abdominal, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::drenaje, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento::fracaso del tratamiento |
| الوصف: | Conservative treatment; Diverticular abscess; Percutaneous drainage ; Tractament conservador; Abscés diverticular; Drenatge percutani ; Tratamiento conservador; Absceso diverticular; Drenaje percutáneo ; Background This multicentre case–control study aimed to identify risk factors associated with non-operative treatment failure for patients with CT scan Hinchey Ib-IIb and WSES Ib-IIa diverticular abscesses. Methods This study included a cohort of adult patients experiencing their first episode of CT-diagnosed diverticular abscess, all of whom underwent initial non-operative treatment comprising either antibiotics alone or in combination with percutaneous drainage. The cohort was stratified based on the outcome of non-operative treatment, specifically identifying those who required emergency surgical intervention as cases of treatment failure. Multivariable logistic regression analysis to identify independent risk factors associated with the failure of non-operative treatment was employed. Results Failure of conservative treatment occurred for 116 patients (27.04%). CT scan Hinchey classification IIb (aOR 2.54, 95%CI 1.61;4.01, P < 0.01), tobacco smoking (aOR 2.01, 95%CI 1.24;3.25, P < 0.01), and presence of air bubbles inside the abscess (aOR 1.59, 95%CI 1.00;2.52, P = 0.04) were independent predictors of failure. In the subgroup of patients with abscesses > 5 cm, percutaneous drainage was not associated with the risk of failure or success of the non-operative treatment (aOR 2.78, 95%CI − 0.66;3.70, P = 0.23). Conclusions Non-operative treatment is generally effective for diverticular abscesses. Tobacco smoking's role as an independent risk factor for treatment failure underscores the need for targeted behavioural interventions in diverticular disease management. IIb Hinchey diverticulitis patients, particularly young smokers, require vigilant monitoring due to increased risks of treatment failure and septic progression. Further research into the efficacy of image-guided percutaneous drainage should ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1432-2218 |
| العلاقة: | Surgical Endoscopy;38(6); https://doi.org/10.1007/s00464-024-10793-zTest; Podda M, Ceresoli M, Di Martino M, Ortenzi M, Pellino G, Pata F, et al. Towards a tailored approach for patients with acute diverticulitis and abscess formation. The DivAbsc2023 multicentre case–control study. Surg Endosc. 2024 Jun;38(6):3180–3194.; https://hdl.handle.net/11351/11553Test; 001204657100002 |
| DOI: | 10.1007/s00464-024-10793-z |
| الإتاحة: | https://doi.org/10.1007/s00464-024-10793-zTest https://hdl.handle.net/11351/11553Test |
| حقوق: | Attribution 4.0 International ; http://creativecommons.org/licenses/by/4.0Test/ ; info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.D7D9D728 |
| قاعدة البيانات: | BASE |
| تدمد: | 14322218 |
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| DOI: | 10.1007/s00464-024-10793-z |