John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


French guidelines for medical and surgical elective care after acute colon diverticulitis Volume 25, issue 10, Décembre 2018

1 AP-HM, Aix-Marseille Université, Hôpital Nord, Service de chirurgie générale et digestive, Chemin des Bourrely, 13015 Marseille, France
2 AP-HP, Université Paris VII, Hôpital Beaujon, Service de chirurgie colorectale, 100 boulevard du Général Leclerc, 92110 Clichy, France
3 CETAD (gastroentérologie), 41 boulevard de La Tour Maubourg, 75007 Paris, France
4 CHRU de Nancy, Hôpital de Brabois, Service de médecine interne, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
5 Centre Hospitalier Saint-Joseph Saint-Luc, Service d’anesthésie-réanimation, 20 Quai Claude Bernard, 69007 Lyon, France
6 Hôpital Foch, Service de biologie clinique, 40 rue Worth, 92150 Suresnes, France
7 CHU de Bordeaux, Service de gériatrie, F-33000 Bordeaux, France
8 Hospices Civils de Lyon, Université de Lyon, Centre Hospitalier Lyon-Sud, Service de radiologie, 165 chemin du grand Revoyet, 69495 Pierre Bénite, France
9 AP-HP, Université Sorbonne, Hôpital Saint-Antoine, Service d’anesthésie-réanimation, 184 rue du faubourg Saint-Antoine, 75571 Paris Cedex 12, France
10 Médecin généraliste,Université Grenoble Alpes, 71 rue des Brassières, 38420 Domène, France
11 Clinique du Parc, Service de chirurgie digestive, 50 rue Emile Combes, 34170 Castelnau Le Lez, France
12 Centre Hospitalier Lyon-Sud, Service de chirurgie digestive, oncologique et endocrinienne, 165 chemin du grand Revoyet, 69495 Pierre Bénite, France
13 AP-HP,Université Sorbonne, Hôpital Saint-Antoine, Service de chirurgie générale et digestive, 184 rue du faubourg Saint-Antoine, 75571 Paris Cedex 12, France
* Tirés à part

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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