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Routine colonoscopy is not required in uncomplicated diverticulitis: a systematic review

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Abstract

Background

It is generally accepted that patients following an episode of diverticulitis should have additional colonoscopy screening to rule out a colorectal malignancy. We aimed to investigate the rate of CRC found by colonoscopy after an attack of uncomplicated diverticulitis.

Methods

MEDLINE, Embase, and Cochrane databases were searched systematically for clinical trials or observational studies on colonic evaluation by colonoscopy after the initial diagnosis of acute uncomplicated diverticulitis, followed by hand-searching of reference lists.

Results

Nine studies met the inclusion criteria and included a total number of 2,490 patients with uncomplicated diverticulitis. Subsequent colonoscopy after an episode of uncomplicated diverticulitis was performed in 1,468 patients (59 %). Seventeen patients were diagnosed with CRC, having a prevalence of 1.16 % (95 % confidence interval 0.72–1.9 % for CRC). Hyperplastic polyps were seen in 156 patients (10.6 %), low-grade adenoma in 90 patients (6.1 %), and advanced adenoma was reported in 32 patients (2.2 %).

Conclusion

Unless colonoscopy is regarded for screening in individuals aged 50 years and older, routine colonoscopy in the absence of other clinical signs of CRC is not required.

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Acknowledgments

The authors thank the following authors for providing additional data on their studies: Prof Frizelle, Dr. Wallace, Dr. Schout, Dr. Ahmeidat, Dr. Alexandersson, and Dr. Schmilovitz.

Disclosures

All authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, St Antonius Hospital, Nieuwegein, The Netherlands

    H. S. de Vries, D. Boerma, B. van Ramshorst & H. L. van Westreenen

  2. Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands

    H. S. de Vries

  3. Department of Gastroenterology, St Antonius Hospital, Nieuwegein, The Netherlands

    R. Timmer

  4. Department of Gastroenterology, University of Alberta, Edmonton, Canada

    L. A. Dieleman

  5. Centre of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada

    L. A. Dieleman

  6. Isala Clinics, Zwolle, The Netherlands

    H. L. van Westreenen

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  1. H. S. de Vries
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Correspondence to H. S. de Vries.

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de Vries, H.S., Boerma, D., Timmer, R. et al. Routine colonoscopy is not required in uncomplicated diverticulitis: a systematic review. Surg Endosc 28, 2039–2047 (2014). https://doi.org/10.1007/s00464-014-3447-4

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  • DOI: https://doi.org/10.1007/s00464-014-3447-4

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