Diagnosis and treatment of diverticular disease -: Results of a consensus development conference
Diagnosis and treatment of diverticular disease -: Results of a consensus development conference
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DOI：
10.1007/s004649901007
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发表时间：
1999-04-01
期刊：
影响因子：
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通讯作者：
Neugebauer, E
中科院分区：
文献类型：
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作者：
Köhler, L;Sauerland, S;Neugebauer, E
背景资料：与解决目前的争议憩室疾病的诊断和治疗的目的，这一共识发展会议着手总结的实际状态的art.Methods：一个多学科小组的国际专家（n = 16）被选中参加共识过程。在会议之前，所有专家都被要求回答一系列关于憩室病的问题。根据这些评价汇编的共识声明在小组成员联席会议上进行了修改，然后提交公开会议讨论，最后由专家小组进行了修订。最后的声明邮寄给所有小组成员批准（德尔菲法）。结果：无症状憩室病，憩室病（实际或复发症状），并复杂的憩室病分别定义。在无并发症的病例中，钡灌肠或结肠镜检查作为初始诊断工具是否更好的选择尚未达成一致意见。在复杂的情况下，建议使用计算机断层扫描进行诊断。憩室病两次发作后，应考虑选择性切除。对于不能排除合并癌和有慢性并发症（瘘、狭窄或出血）的患者，也需要手术。腹腔镜乙状结肠切除术，建议只为简单的，经皮引流的脓肿后，Hinchey阶段I和II cases.Conclusions：腹腔镜手术已经开始影响憩室疾病的管理，但随机对照试验需要支持治疗决策在很大程度上是失踪。
Background: With the aim of resolving the current controversy over the diagnosis and treatment of diverticular disease, this consensus development conference set out to summarize the actual state of the art.Methods: A multidisciplinary panel of international experts (n = 16) was selected to take part in the consensus process. Prior to the conference, all experts were asked to answer a series of questions on diverticular disease. The consensus statement compiled out of these evaluations was modified during a joint meeting of the panel members, then presented for discussion in a public session, and finally revised by the expert panel. The finalized statement was mailed to all panel members for approval (Delphi method).Results: Asymptomatic diverticulosis, diverticular disease (with actual or recurrent symptoms), and complicated diverticular disease were defined separately. No agreement was reached on whether barium enema or colonoscopy is the better choice as an initial diagnostic tool in uncomplicated cases. In complicated cases, computed tomography is recommended for diagnosis. After two attacks of diverticular disease, elective resection should be considered. For patients in whom a concomitant carcinoma cannot be excluded and those with chronic complications (fistula, stenosis, or bleeding) surgery is also indicated. Laparoscopic sigmoid colectomy is recommended only for uncomplicated and, after percutaneous drainage of abscesses, Hinchey stage I and II cases.Conclusions: Laparoscopic surgery has already begun to influence the management of diverticular disease, but the randomized controlled trials needed to support therapy decisions are largely missing.