Hawkins Alexander T, Ueland Thomas E
Division of General Surgery, Section of Colon & Rectal Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Vanderbilt University School of Medicine, Nashville, Tennessee.
Clin Colon Rectal Surg. 2024 Oct 4;38(4):283-289. doi: 10.1055/s-0044-1791558. eCollection 2025 Jul.
Achieving optimal outcomes is a universal goal among health care providers. However, disagreement often arises when selecting and measuring endpoints as markers of care performance. In diverticulitis, this task is complicated by variability in clinical presentation and existence of multiple evidence-based therapeutic options. The aim of this review is to summarize trends and challenges in outcomes measurement for diverticulitis. We discuss historical origins and compare existing frameworks for classifying outcomes. Next, focus is directed to an exploration of important outcomes through clinical controversies: antibiotics for acute uncomplicated diverticulitis, colectomy with primary anastomosis for acute complicated diverticulitis, and elective colectomy for recurrent diverticulitis. Finally, we review recommendations supporting case-by-case decision-making and implications for clinicians, in addition to ongoing international efforts to standardize outcomes that matter for common diseases.
实现最佳治疗效果是医疗服务提供者的共同目标。然而,在选择和衡量作为医疗绩效指标的终点时,常常会出现分歧。在憩室炎中,临床表现的变异性和多种循证治疗方案的存在使这项任务变得复杂。本综述的目的是总结憩室炎治疗效果评估的趋势和挑战。我们讨论其历史渊源,并比较现有的结局分类框架。接下来,通过临床争议探讨重要结局:急性单纯性憩室炎的抗生素治疗、急性复杂性憩室炎的一期吻合结肠切除术,以及复发性憩室炎的择期结肠切除术。最后,我们除了回顾支持个体化决策的建议及其对临床医生的影响外,还审视了国际上为规范常见疾病重要结局所做的持续努力。