Khirurgiia · 2026
[Modern diagnostic and treatment approach for colonic diverticulitis in the Russian Federation: survey of specialists].
Аннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Nechay T V, Smirnova O A, Tyagunov A E, Gusev L L, Kulaev S N, Yuldashev A G, Atroshchenko A O, Semenov Zh S, Sazhin A V
Аннотация
OBJECTIVE: Investigation of the causes of differences between current and recommended therapeutic and diagnostic tactics for colon diverticulitis (CD).
MATERIAL AND METHODS: An anonymous online survey was conducted from 01.2023 for 60 days. The participants received an information letter and a link to an online questionnaire. Demographic indicators, the level of self-esteem, sources of motivation in decision-making, diagnostic and therapeutic tactics were studied. The respondent's probability of choosing a specific treatment tactic was estimated in scores from 0 to 10.
RESULTS: 377 respondents from the Russian Federation participated: 56 (14.9%) coloproctologists (CP), 299 (79.4%) general surgeons (GS), 22 who did not specify a specialty. The majority (46/56, 82.1%) of CP rate their knowledge of the problem as excellent and good, among GS the corresponding proportion is 199 (66.5%) (p=0.02). When making decisions, respondents were most often guided by professional experience (Me 8, Q1-Q3 6-10), methods adopted in the clinic (Me 8, Q1-Q3 5-10) and Russian guidelines (Me 9, Q1-Q3 7-10). A weak relationship was found between reliance on personal experience and the level of self-esteem (r=0.188, p<0.001), as well as the number of colorectal resections performed per year (r=0.242, p<0.001) and between reliance on national recommendations and the level of knowledge on the diagnosis and treatment of CD (r=0.223, p<0.001). Nineteen (5%) respondents for Hinchey IA and 91 (24%) respondents for Hinchey IB-II choose colon resection. In Hinchey III, non-operating specialists choose tactics that are inconsistent with the guidelines (lavage) (p<0.001). For Hinchey IV 35 (9.3%) respondents also offered non-radical treatment options. There is no consensus on issues not covered by guidelines.
CONCLUSION: There is low adherence to the existing recommendations that leads to significant differences in the approaches practiced by respondents from different cohorts. Further research is needed to fill in the gaps found and update the guidelines accordingly.
MATERIAL AND METHODS: An anonymous online survey was conducted from 01.2023 for 60 days. The participants received an information letter and a link to an online questionnaire. Demographic indicators, the level of self-esteem, sources of motivation in decision-making, diagnostic and therapeutic tactics were studied. The respondent's probability of choosing a specific treatment tactic was estimated in scores from 0 to 10.
RESULTS: 377 respondents from the Russian Federation participated: 56 (14.9%) coloproctologists (CP), 299 (79.4%) general surgeons (GS), 22 who did not specify a specialty. The majority (46/56, 82.1%) of CP rate their knowledge of the problem as excellent and good, among GS the corresponding proportion is 199 (66.5%) (p=0.02). When making decisions, respondents were most often guided by professional experience (Me 8, Q1-Q3 6-10), methods adopted in the clinic (Me 8, Q1-Q3 5-10) and Russian guidelines (Me 9, Q1-Q3 7-10). A weak relationship was found between reliance on personal experience and the level of self-esteem (r=0.188, p<0.001), as well as the number of colorectal resections performed per year (r=0.242, p<0.001) and between reliance on national recommendations and the level of knowledge on the diagnosis and treatment of CD (r=0.223, p<0.001). Nineteen (5%) respondents for Hinchey IA and 91 (24%) respondents for Hinchey IB-II choose colon resection. In Hinchey III, non-operating specialists choose tactics that are inconsistent with the guidelines (lavage) (p<0.001). For Hinchey IV 35 (9.3%) respondents also offered non-radical treatment options. There is no consensus on issues not covered by guidelines.
CONCLUSION: There is low adherence to the existing recommendations that leads to significant differences in the approaches practiced by respondents from different cohorts. Further research is needed to fill in the gaps found and update the guidelines accordingly.