American journal of surgery · 2018
A novel endoscopic grading system for prediction of disease-related outcomes in patients with diverticulosis.
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Dean Meara, Valentino Joseph, Ritter Kaitlin, Church James
Аннотация
BACKGROUND: We describe a simple endoscopic grading system of diverticular disease for the assessment of disease severity and prediction of outcomes.
METHODS: A retrospective analysis of prospectively maintained colonoscopy database was conducted. A single endoscopist prospectively graded disease severity according to the number and size of diverticula, the degree of muscular hypertrophy and rigidity of the sigmoid colon.
RESULTS: 762 patients were included in the analysis. Mean patient age was 70 years (range 37-97). Endoscopic severity of diverticulosis was predictive of the need for surgery, with 2% in the mild-moderate, 12% in the severe and 33% in the acute group (p < 0001). Time to surgery showed correlation to severity grade, with mean periods of 107.5 months in the moderate group vs. 3 and 2.5 months in the severe and acute group (p < 0001). The mean follow up was 11 years.
CONCLUSION: Surgeons should consider using endoscopic grading as an adjunct to clinical management decisions.
METHODS: A retrospective analysis of prospectively maintained colonoscopy database was conducted. A single endoscopist prospectively graded disease severity according to the number and size of diverticula, the degree of muscular hypertrophy and rigidity of the sigmoid colon.
RESULTS: 762 patients were included in the analysis. Mean patient age was 70 years (range 37-97). Endoscopic severity of diverticulosis was predictive of the need for surgery, with 2% in the mild-moderate, 12% in the severe and 33% in the acute group (p < 0001). Time to surgery showed correlation to severity grade, with mean periods of 107.5 months in the moderate group vs. 3 and 2.5 months in the severe and acute group (p < 0001). The mean follow up was 11 years.
CONCLUSION: Surgeons should consider using endoscopic grading as an adjunct to clinical management decisions.