Abstract：
BACKGROUND:Acute colonic diverticulitis is a common clinical condition. Severity of the disease is based on clinical, laboratory, and radiological investigations and dictates the need for medical or surgical intervention. Recent clinical trials have improved the understanding of the natural history of the disease resulting in new approaches to and better evidence for the management of acute diverticulitis. METHODS:We searched the Cochrane Library (years 2004-2015), MEDLINE (years 2004-2015), and EMBASE (years 2004-2015) databases. We used the search terms "diverticulitis, colonic" or "acute diverticulitis" or "divertic*" in combination with the terms "management," "antibiotics," "non-operative," or "surgery." Registers for clinical trials (such as the WHO registry and the https://clinicaltrials.gov/ ) were searched for ongoing, recruiting, or closed trials not yet published. RESULTS:Antibiotic treatment can be avoided in simple, non-complicated diverticulitis and outpatient management is safe. The management of complicated disease, ranging from a localized abscess to perforation with diffuse peritonitis, has changed towards either percutaneous or minimally invasive approaches in selected cases. The role of laparoscopic lavage without resection in perforated non-fecal diverticulitis is still debated; however, recent evidence from two randomised controlled trials has found a higher re-intervention in this group of patients. CONCLUSIONS:A shift in management has occurred towards conservative management in acute uncomplicated disease. Those with uncomplicated acute diverticulitis may be treated without antibiotics. For complicated diverticulitis with purulent peritonitis, the use of peritoneal lavage appears to be non-superior to resection.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Boermeester MA,Humes DJ,Velmahos GC,Søreide Kdoi
10.1007/s00268-016-3560-8subject
Has Abstractpub_date
2016-10-01 00:00:00pages
2537-45issue
10eissn
0364-2313issn
1432-2323pii
10.1007/s00268-016-3560-8journal_volume
40pub_type
杂志文章,评审abstract：BACKGROUND:The present study was designed to evaluate the impact of the tyrosine kinase ligands VEGF-A/C/D, PDGF-A/B on tumor dissemination and survival in gastric cancer. This is the first study analyzing all these parameters in a homogeneous patient population undergoing surgery. METHODS:The expression pattern of VE...
journal_title：World journal of surgery
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journal_title：World journal of surgery
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abstract：: ...
journal_title：World journal of surgery
pub_type： 评论,信件
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
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pub_type： 临床试验,杂志文章,随机对照试验
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pub_type： 杂志文章
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更新日期：2019-03-01 00:00:00
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pub_type： 杂志文章
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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