Hépato-Gastro & Oncologie Digestive
MENUFrench guidelines for medical and surgical elective care after acute colon diverticulitis Volume 25, issue 10, Décembre 2018
- Key words: diverticulitis, prevention, surgery, sigmoid colectomy, quality of life
- DOI : 10.1684/hpg.2018.1707
- Page(s) : 989-1000
- Published in: 2018
The 2006 French recommendations on the management of diverticulitis have been updated. Systematic elective sigmoidectomy after acute diverticulitis is not recommended in asymptomatic patients and/or under 50 years of age. On the other hand, it is recommended to discuss elective sigmoidectomy in the course of complicated acute diverticulitis (abscess), and in the immunosuppressed or chronic renal failure patients, by integrating their associated operative risk factors. An elective sigmoidectomy will also be proposed in case of persistent symptoms after a flare (e.g. smoldering diverticulitis) or frequent recurrences impacting quality of life. In this context, laparoscopy is the gold standard and the recto-sigmoid junction must be resected. Enhanced recovery is recommended. As for the prevention from diverticulitis recurrence, neither diets nor medications (probiotics, rifaximin, mesalamine) are recommended.
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