Conservative treatment of uncomplicated right-sided diverticulitis: a systematic review and meta-analysis
- Authors
- Lee, Jun Ho; Ahn, Byung Kyu; Lee, Kang Hong
- Issue Date
- Aug-2021
- Publisher
- SPRINGER
- Keywords
- Right-sided diverticulitis; Uncomplicated diverticulitis; Conservative treatment; Recurrence
- Citation
- INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, v.36, no.8, pp.1791 - 1799
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
- Volume
- 36
- Number
- 8
- Start Page
- 1791
- End Page
- 1799
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/141450
- DOI
- 10.1007/s00384-021-03913-x
- ISSN
- 0179-1958
- Abstract
- Purpose
Right-sided diverticulitis has different epidemiologic features compared to left-sided diverticulitis. However, data on the appropriate treatment of right-sided diverticulitis are lacking. This systematic review aimed to examine the outcomes of conservative treatment for uncomplicated right-sided diverticulitis.
Methods
MEDLINE, Embase, and the Cochrane Library were searched for articles published from January 1, 1990, to May 31, 2020. A total of 21 studies were included in the systematic review. We calculated proportions and 95% confidence intervals (CIs) to assess the outcomes of individual studies and pooled the results using a random effects model.
Results
A total of 2811 patients (59.1% men; mean and median age, 37–54 years) with right-sided diverticulitis were included. The pooled rate of treatment failure was 2.5% (95% CI 1.2–4.3%; p <0.01; I2 = 64.0%). The recurrence rate ranged from 0 to 26.9%, and the pooled recurrence rate was 10.9% (95% CI 8.1–14.1%; p <0.01; I2 = 78.2%). The pooled rate of complicated diverticulitis at recurrence was 4.4% (95% CI 1.4–9.0%; p = 0.84; I2 = 0%). The pooled rate of emergency surgery at recurrence was 9.0% (95% CI 4.6–14.7%; p = 0.12; I2 = 30.3%).
Conclusions
Conservative treatment of uncomplicated right-sided diverticulitis results in a low rate of recurrence and complicated diverticulitis at recurrence. Based on these results, unnecessary surgery may be avoided and a new treatment paradigm for uncomplicated right-sided diverticulitis may be introduced.
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