Agresta Ferdinando, Montori Giulia, Podda Mauro, Ortenzi Monica, Giordano Alessio, Bergamini Carlo, Mazzarolo Giorgio, Licitra Edelweiss, Gobbi Tobia, Procida Giuseppa, Borgo Andrea Dal, Botteri Emanuele, Ansaloni Luca, Fugazzola Paola, Savino Grazia, Guerrieri Mario, Campanile Fabio Cesare, Sartori Alberto, Petz Wanda, Silecchia Gianfranco, di Saverio Salomone, Catena Fausto, Agrusa Antonino, Salemi Michelangelo, Morales-Conde Salvador, Arezzo Alberto
Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy.
Department of Surgical Science, University of Cagliari, Cagliari, Italy.
Eur J Trauma Emerg Surg. 2024 Feb;50(1):81-91. doi: 10.1007/s00068-023-02362-1. Epub 2023 Sep 25.
Emergency treatment of acute diverticulitis remains a hazy field. Despite a number of clinical studies, randomized controlled trials (RCTs), guidelines and surgical societies recommendations, the most critical hot topics have yet to be addressed.
Literature research from 1963 until today was performed. Data regarding the principal RCTs and observational studies were summarized in descriptive tables. In particular we aimed to focus on the following topics: the role of laparoscopy, the acute care setting, the RCTs, guidelines, observational studies and classifications proposed by literature, the problem in case of a pandemic, and the importance of adapting treatment /place/surgeon conditions.
In the evaluation of these points we did not try to find any prospective evolution of the concepts achievements. On the contrary we simply report the individuals strands of research from a retrospective point of view, similarly to what Steve Jobes said: "you can't connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future". We have finally obtained what can be defined "a narrative review of the literature on diverticulitis".
Not only evidence-based medicine but also the contextualization, as also the role of 'competent' surgeons, should guide to novel approach in acute diverticulitis management.
急性憩室炎的急诊治疗仍是一个模糊的领域。尽管有大量临床研究、随机对照试验（RCT）、指南以及外科协会的建议，但最关键的热点问题仍未得到解决。
进行了从1963年至今的文献研究。关于主要随机对照试验和观察性研究的数据总结在描述性表格中。我们特别关注以下主题：腹腔镜检查的作用、急性护理环境、随机对照试验、指南、观察性研究以及文献中提出的分类、大流行情况下的问题，以及适应治疗/地点/外科医生条件的重要性。
在对这些要点的评估中，我们并未试图找出这些概念成就的任何前瞻性演变。相反，我们只是从回顾的角度简单报告各个研究线索，就像史蒂夫·乔布斯所说：“你不能瞻前顾后地将点点滴滴联系起来；你只能在回首往事时将它们联系起来。所以你必须相信，这些点滴在未来会以某种方式联系起来”。我们最终得到了可以定义为“憩室炎文献的叙述性综述”的内容。
不仅循证医学，而且情境化以及“有能力的”外科医生的作用，都应指导急性憩室炎管理的新方法。
