Abstract
Background
The timing of elective surgery of colonic diverticulitis in young patients remains controversial. The present meta-analysis aimed to answer the question whether these patients should be operated after the first attack or, more classically, after the second attack.
Materials and methods
Electronic databases were searched for papers reporting the results of surgery according to the strategies. Major endpoint was the performance of a colostomy (during unplanned surgery or for anastomotic dehiscence complicating elective surgery).
Results
Fifteen papers were selected for potential inclusion in the meta-analysis. But, eventually, only three papers gave information about the timing of surgery. Pooling the data of these 3 studies showed that 160 patients underwent elective surgery after the first attack and only 5 patients underwent subsequent emergent surgery at the course of their disease. Hence, no meta-analysis could be performed.
Conclusion
Researchers should no longer attempt (like us) to answer this question by any meta-analysis. The failure of the present meta-analysis highlights the limitations of evidence-based surgery in some particular fields.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Zaidi E, Daly B (2006) CT and clinical features of acute diverticulitis in an urban U.S. population: rising frequency in young, obese adults. AJR Am J Roentgenol 187:689–694
Stollman NH, Raskin JB (1999) Ad hoc practice parameters of the American College of Gastroenterology. Diagnosis and management of diverticular disease of the colon in adults. Am J Gastroenterol 94:3110–3121
Rafferty J, Shellito P, Hyman NH, Buie WD, Standards Committee of the ASCRS (2006) Practice parameters for sigmoid diverticulitis. Dis Colon Rectum 49:939–944
Wong WD, Wexner SD, Lowry A, Vernava A III, Burnstein M, Denstman F, Fazio V, Kerner B, Moore R, Oliver G, Peters W, Ross T, Senatore P, Simmang C (2000) Practice parameters for the treatment of sigmoid diverticulitis—supporting documentation. Dis Colon Rectum 43:290–297
Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF (2000) Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. QUOROM group. Br J Surg 87:1448–1454
Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73:712–716
Slim K (2005) Limits of evidence-based surgery. World J Surg 29:606–609
Norris SL, Atkins D (2005) Challenges in using nonrandomized studies in systematic reviews of treatment interventions. Ann Intern Med 142:1112–1119
Mahid SS, Hornung CA, Minor KS, Turina M, Galandiuk S (2006) Systematic reviews and meta-analysis for the surgeon scientist. Br J Surg 93:1315–1324
Anaya DA, Flum DR (2005) Risk of emergency colectomy and colostomy in patients with diverticular disease. Arch Surg 140:681–685
Salem L, Veenstra DL, Sullivan SD, Flum DR (2004) The timing of elective colectomy in diverticulitis: A decision analysis. J Am Coll Surg 199:904–912
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Slim, K., Raspado, O., Brugère, C. et al. Failure of a meta-analysis on the role of elective surgery for left colonic diverticulitis in young patients. Int J Colorectal Dis 23, 665–667 (2008). https://doi.org/10.1007/s00384-008-0472-6
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00384-008-0472-6