Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
Division of Gastroenterology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Korean J Intern Med. 2023 Sep;38(5):672-682. doi: 10.3904/kjim.2023.133. Epub 2023 Aug 17.
BACKGROUND/AIMS: Some management strategies for acute colonic diverticulitis remain controversial in Korean real-world practice because their clinical features differ from those in the West. This study aimed to investigate the opinions of Korean physicians regarding the diagnosis and treatment of acute diverticulitis.
A web-based survey was conducted among gastroenterologists specializing on treating lower gastrointestinal disorders. The questionnaires concerned overall management strategies for colonic diverticulitis, including diagnosis, treatment, and follow-up.
In total, 209 gastroenterologists responded to the survey. Less than one-fourth of the respondents (23.6%) answered that left-sided colonic diverticulitis is more likely to be complicated than right-sided colonic diverticulitis. Most respondents agreed that immunocompromised patients with diverticulitis have worse clinical outcomes than immunocompetent patients (71.3%). Computed tomography was the most preferred tool for diagnosing diverticulitis (93.9%). Approximately 89% of the respondents answered that they believed antibiotic treatment is necessary to treat acute uncomplicated diverticulitis. Most respondents (92.6%) agreed that emergency surgery is not required for diverticulitis with an abscess or microperforation without panperitonitis. Further, 94.7% of the respondents agreed that colon cancer screening is necessary in patients aged ≥ 50 years with diverticulitis after they have recovered from acute illness. Many respondents (71.4%) agreed that surgery for recurrent diverticulitis should be individualized.
Opinions regarding management strategies for colonic diverticulitis among Korean gastroenterologists were well agreed upon in some areas but did not agree well in other areas. Evidence-based guidelines that meet the practical needs of the Korean population should be developed.
背景/目的：由于韩国的临床特征与西方不同，因此急性结肠憩室炎的一些管理策略在韩国的实际实践中仍存在争议。本研究旨在探讨韩国医生对急性憩室炎的诊断和治疗的看法。
对专门治疗下消化道疾病的胃肠病学家进行了基于网络的调查。问卷涉及结肠憩室炎的总体管理策略，包括诊断，治疗和随访。
共有 209 名胃肠病学家对调查做出了回应。不到四分之一的受访者（23.6％）回答说左侧结肠憩室炎比右侧结肠憩室炎更有可能复杂化。大多数受访者认为免疫功能低下的憩室炎患者的临床结局比免疫功能正常的患者差（71.3％）。计算机断层扫描是诊断憩室炎的最首选工具（93.9％）。大约 89％的受访者回答说，他们认为抗生素治疗对于治疗急性单纯性憩室炎是必要的。大多数受访者（92.6％）同意对于没有腹膜炎的脓肿或微穿孔的憩室炎，不需要急诊手术。此外，94.7％的受访者同意对于患有憩室炎的年龄≥50 岁的患者，在急性疾病康复后，有必要进行结肠癌筛查。许多受访者（71.4％）同意，对于复发性憩室炎的手术应因人而异。
韩国胃肠病学家对结肠憩室炎的管理策略的意见在某些方面得到了很好的认同，但在其他方面则没有得到很好的认同。应制定符合韩国人口实际需求的循证指南。
