Department of Surgery, St Antonius Hospital, Nieuwegein, The Netherlands,
Surg Endosc. 2014 Jul;28(7):2039-47. doi: 10.1007/s00464-014-3447-4. Epub 2014 Feb 1.
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.
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.
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%).
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.
一般认为，患有憩室炎的患者应进行额外的结肠镜筛查，以排除结直肠恶性肿瘤。我们旨在研究在非复杂性憩室炎发作后通过结肠镜检查发现 CRC 的比率。
系统地在 MEDLINE、Embase 和 Cochrane 数据库中搜索了关于在急性非复杂性憩室炎初始诊断后通过结肠镜检查进行结肠评估的临床试验或观察性研究，并对参考文献进行了手工搜索。
符合纳入标准的 9 项研究共纳入了 2490 例非复杂性憩室炎患者。1468 例（59%）在非复杂性憩室炎发作后进行了后续结肠镜检查。17 例被诊断为 CRC，患病率为 1.16%（95%置信区间为 CRC 的 0.72-1.9%）。156 例患者发现有增生性息肉，90 例患者发现有低级别腺瘤，32 例患者发现有高级别腺瘤。
除非在 50 岁及以上的人群中进行筛查，否则在没有其他 CRC 临床迹象的情况下，不要求常规进行结肠镜检查。
