Department of General-, Abdominal-, Endocrine- and Minimally Invasive Surgery, München Klinik Bogenhausen, Munchen, Germany
Department of General-, Abdominal-, Endocrine- and Minimally Invasive Surgery, München Klinik Bogenhausen, Munchen, Germany.
BMJ Open. 2020 Dec 31;10(12):e042350. doi: 10.1136/bmjopen-2020-042350.
Acute diverticulitis of the sigmoid colon is increasingly treated by a non-operative approach. The need for colectomy after recovery from a flare of acute diverticulitis of the left colon, complicated diverticular abscess is still controversial. The primary aim of this study is to assess the risk of interval emergency surgery by systematic review and meta-analysis.
The systematic review and meta-analysis will be conducted in accordance to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. PubMed/MEDLINE, Cochrane Central Register of Controlled Trials and EMBASE will be screened for the predefined searching term: (Diverticulitis OR Diverticulum) AND (Abscess OR pelvic abscess OR pericolic abscess OR intraabdominal abscess) AND (surgery OR operation OR sigmoidectomy OR drainage OR percutaneous drainage OR conservative therapy OR watchful waiting). All studies published in an English or German-speaking peer-reviewed journal will be suitable for this analysis. Case reports, case series of less than five patients, studies without follow-up information, systematic and non-systematic reviews and meta-analyses will be excluded. Primary endpoint is the rate of interval emergency surgery. Using the Review Manager Software (Review Manager/RevMan, V.5.3, Copenhagen, The Nordic Cochrane Centre, The Cochrane Collaboration, 2012) meta-analysis will be pooled using the Mantel-Haenszel method for random effects. The Risk of Bias in Non-randomized Studies of Interventions tool will be used to assess methodological quality of non-randomised studies. Risk of bias in randomised studies will be assessed using the Cochrane developed RoB 2-tool.
As no new data are being collected, ethical approval is exempt for this study. This systematic review is to provide a new insight on the need for surgical treatment after a first attack of acute diverticulitis, complicated by intra-abdominal or pelvic abscesses. The results of this study will be presented at national and international meetings and published in a peer-reviewed journal.
CRD42020164813.
乙状结肠急性憩室炎越来越多地采用非手术治疗。左结肠急性憩室炎发作并伴有复杂憩室脓肿后是否需要结肠切除术仍存在争议。本研究的主要目的是通过系统评价和荟萃分析评估间隔期急诊手术的风险。
系统评价和荟萃分析将按照系统评价和荟萃分析报告的首选报告项目进行。将在 PubMed/MEDLINE、Cochrane 对照试验中心注册库和 EMBASE 中筛选预定义的搜索词：（憩室炎或憩室）和（脓肿或盆腔脓肿或结肠旁脓肿或腹腔脓肿）和（手术或操作或乙状结肠切除术或引流或经皮引流或保守治疗或观察等待）。所有发表在英文或德文同行评议期刊上的研究都适合本分析。病例报告、少于 5 例的病例系列、无随访信息的研究、系统和非系统综述和荟萃分析将被排除在外。主要终点是间隔期急诊手术的发生率。使用 Review Manager 软件（Review Manager/RevMan，V.5.3，Copenhagen，The Nordic Cochrane Centre，The Cochrane Collaboration，2012），使用随机效应的 Mantel-Haenszel 方法进行荟萃分析。将使用非随机干预研究的风险偏倚工具（Risk of Bias in Non-randomized Studies of Interventions tool）评估非随机研究的方法学质量。使用 Cochrane 开发的 RoB 2 工具评估随机研究的偏倚风险。
由于没有收集新数据，因此本研究无需伦理批准。本系统评价旨在为首次急性憩室炎发作并伴有腹腔或盆腔脓肿的患者是否需要手术治疗提供新的见解。该研究的结果将在国内外会议上展示，并发表在同行评议的期刊上。
PROSPERO 注册号：CRD42020164813。
