Evidence-based Reviews in Surgery Long-term Outcome of Surgery Versus Conservative Management for Recurrent and Ongoing Complaints After an Episode of Diverticulitis: Five-year Follow-up Results of a Multicenter Randomized Controlled Trial (DIRECT-Trial).

Annals of Surgery
Sunil V Patelfor Members of the Evidence Based Reviews in Surgery group

Abstract

Does surgery or conservative management of recurring diverticulitis/ongoing symptoms results in a higher quality of life (QoL) at 5-year follow-up. Randomized controlled trial. Multicenter trial in the Netherlands. Patients aged 18 to 75 years, who presented with either ongoing abdominal complaints (for >3 months) and/or frequently recurring left-sided diverticulitis (>2 episodes in 2 years) after an objectified (via Computed Tomography, Ultrasound or Endoscopy) episode of diverticulitis were included in this study. Elective Sigmoid Resection within 6 weeks vs. Conservative Management MAIN OUTCOME:: QoL at 5-year follow-up, as measured by the Gastrointestinal Quality of Life Index (GIQLI). Secondary outcomes included additional QoL assessments (including the EuroQoL-5D-3L, Visual Analogue Score for pain, and the short form 36 health survey) RESULTS:: The intention to treat analysis showed the surgical group had a higher quality of life (GIQLI) score than the conservative group (mean difference 9.7, 95% confidence interval 1.7-17.7, P = 0.018), which approached but did not meet the minimum important difference of 10. This difference was achieved in 67% of those in the operative group versus 57% in the conservative group (many of...Continue Reading

References

Nov 4, 1992·JAMA : the Journal of the American Medical Association·UNKNOWN Evidence-Based Medicine Working Group
Feb 20, 1998·BMJ : British Medical Journal·B Sibbald, M Roland
Aug 25, 1999·Lancet·S Pocock, I White
Feb 21, 2002·Lancet·Kenneth F Schulz, David A Grimes
Feb 13, 2009·Annals of Surgery·Antonello ForgioneJacques Marescaux
Aug 10, 2010·BMC Surgery·Bryan J M van de WallUNKNOWN Dutch Diverticular Disease (3D) Collaborative Study Group
Oct 25, 2011·International Journal of Surgery·Kenneth F SchulzUNKNOWN CONSORT Group
Feb 11, 2014·Diseases of the Colon and Rectum·Daniel FeingoldJanice Frederick Rafferty
Nov 28, 2014·International Journal of Colorectal Disease·B Vinson-BonnetL Siproudhis
Apr 12, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Chelle L Wheat, Lisa L Strate
Aug 26, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Caroline S AndewegHarry van Goor
Apr 14, 2017·The Lancet. Gastroenterology & Hepatology·Bryan J M van de WallUNKNOWN DIRECT trial collaborators
May 2, 2018·Annals of Internal Medicine·Sophia M Swanson, Lisa L Strate
Jun 7, 2018·JAMA : the Journal of the American Medical Association·Kristine Broglio

❮ Previous
Next ❯

Citations

Mar 18, 2021·World Journal of Gastroenterology : WJG·Mark H Hanna, Andreas M Kaiser

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

© 2021 Meta ULC. All rights reserved