Una revisión sistemática | 14 ABR 14

Cirugía para la diverticulitis en el siglo XXI

Los autores de este trabajo han realizado una revisión sistemática de reportes primarios recientes sobre la toma de decisión, aspectos técnicos y resultados de la cirugía para la diverticulitis sigmoidea aguda, recurrente y crónica.
Autor/a: Dres. Regenbogen SE, Hardiman KM, Hendren S, Morris AM, JAMA Surg 2014; 149(3): 292-303
INDICE:  1.  | 2. 

1.    Etzioni  DA, Mack  TM, Beart  RW  Jr, Kaiser  AM.  Diverticulitis in the United States: 1998-2005: changing patterns of disease and treatment. Ann Surg. 2009;249(2):210-217.
2.     Ricciardi  R, Baxter  NN, Read  TE, Marcello  PW, Hall  J, Roberts  PL.  Is the decline in the surgical treatment for diverticulitis associated with an increase in complicated diverticulitis? Dis Colon Rectum. 2009;52(9):1558-1563.
3.    Centers for Disease Control and Prevention; National Center for Health Statistics. CDC/NCHS National Hospital Discharge Survey, 2010. http://www.cdc.gov.elibrary.einstein.yu.edu/nchs/. Accessed April 5, 2013.
4.    Yen  L, Davis  KL, Hodgkins  P, Loftus  EV  Jr, Erder  MH.  Direct costs of diverticulitis in a US managed care population. Am J Pharm Benefits. 2012;4(5):e118-e129.
5.    Ambrosetti  P.  Value of CT for acute left-colonic diverticulitis: the surgeon’s view. Dig Dis. 2012;30(1):51-55.
6.    Ambrosetti  P, Becker  C, Terrier  F.  Colonic diverticulitis: impact of imaging on surgical management: a prospective study of 542 patients. Eur Radiol. 2002;12(5):1145-1149.
7.    Janes  S, Meagher  A, Frizelle  FA.  Elective surgery after acute diverticulitis. Br J Surg. 2005;92(2):133-142.
8.    Collins  D, Winter  DC.  Elective resection for diverticular disease: an evidence-based re-view. World J Surg. 2008;32(11):2429-2433.
9.    Salem  L, Anaya  DA, Flum  DR.  Temporal changes in the management of diverticulitis. J Surg Res. 2005;124(2):318-323.
10.    Rafferty  J, Shellito  P, Hyman  NH, Buie  WD; Standards Committee of American Society of Colon and Rectal Surgeons.  Practice parameters for sigmoid diverticulitis. Dis Colon Rectum. 2006;49(7):939-944.
11.    Etzioni  DA, Cannom  RR, Ault  GT, Beart  RW  Jr, Kaiser  AM.  Diverticulitis in California from 1995 to 2006: increased rates of treatment for younger patients. Am Surg. 2009;75(10):981-985.
12.    Cohen  ME, Bilimoria  KY, Ko  CY, Hall  BL.  Development of an American College of Sur-geons National Surgery Quality Improvement Program: morbidity and mortality risk calcula-tor for colorectal surgery. J Am Coll Surg. 2009;208(6):1009-1016.
13.    Schilling  PL, Dimick  JB, Birkmeyer  JD.  Prioritizing quality improvement in general sur-gery. J Am Coll Surg. 2008;207(5):698-704.
14.    Munson  KD, Hensien  MA, Jacob  LN, Robinson  AM, Liston  WA.  Diverticulitis: a comprehensive follow-up. Dis Colon Rectum. 1996;39(3):318-322.
15.    Thörn  M, Graf  W, Stefànsson  T, Påhlman  L.  Clinical and functional results after elective colonic resection in 75 consecutive patients with diverticular disease. Am J Surg. 2002;183(1):7-11.
16.    Egger  B, Peter  MK, Candinas  D.  Persistent symptoms after elective sigmoid resection for diverticulitis. Dis Colon Rectum. 2008;51(7):1044-1048.
17.    Morris  AM, Hardiman  KM, Regenbogen  SE, Hendren  S.  Sigmoid diverticulitis: a system-atic review . JAMA. 2014;311(3). doi:10.1001/jama.2013.282025.
18.    Wong  WD, Wexner  SD, Lowry  A,  et al; Standards Task Force, American Society of Colon and Rectal Surgeons.  Practice parameters for the treatment of sigmoid diverticulitis: supporting documentation. Dis Colon Rectum. 2000;43(3):290-297.
19.    Stroup  DF, Berlin  JA, Morton  SC,  et al; Meta-analysis of Observational Studies in Epide-miology (MOOSE) Group.  Meta-analysis of observational studies in epidemiology: a pro-posal for reporting. JAMA. 2000;283(15):2008-2012.
20.    Gibbons  RJ, Smith  S, Antman  E; American College of Cardiology; American Heart Asso-ciation.  American College of Cardiology/American Heart Association clinical practice guidelines: part I: where do they come from? Circulation. 2003;107(23):2979-2986.
21.    Liberati  A, Altman  DG, Tetzlaff  J,  et al.  The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.
22.    Ambrosetti  P, Chautems  R, Soravia  C, Peiris-Waser  N, Terrier  F.  Long-term outcome of mesocolic and pelvic diverticular abscesses of the left colon: a prospective study of 73 cases. Dis Colon Rectum. 2005;48(4):787-791.
23.    Costi  R, Cauchy  F, Le Bian  A, Honart  JF, Creuze  N, Smadja  C.  Challenging a classic myth: pneumoperitoneum associated with acute diverticulitis is not an indication for open or laparoscopic emergency surgery in hemodynamically stable patients: a 10-year experience with a nonoperative treatment. Surg Endosc. 2012;26(7):2061-2071.
24.    Dharmarajan  S, Hunt  SR, Birnbaum  EH, Fleshman  JW, Mutch  MG.  The efficacy of non-operative management of acute complicated diverticulitis. Dis Colon Rectum. 2011;54(6):663-671.
25.    Gaertner  WB, Willis  DJ, Madoff  RD,  et al.  Percutaneous drainage of colonic diverticular abscess: is colon resection necessary? Dis Colon Rectum. 2013;56(5):622-626.
26.    Kaiser  AM, Jiang  JK, Lake  JP,  et al.  The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol. 2005;100(4):910-917.
27.    Poletti  PA, Platon  A, Rutschmann  O,  et al.  Acute left colonic diverticulitis: can CT find-ings be used to predict recurrence? AJR Am J Roentgenol. 2004;182(5):1159-1165.
28.    Chapman  J, Davies  M, Wolff  B,  et al.  Complicated diverticulitis: is it time to rethink the rules? Ann Surg. 2005;242(4):576-581, discussion 581-583.
29.    Boostrom  SY, Wolff  BG, Cima  RR, Merchea  A, Dozois  EJ, Larson  DW.  Uncomplicated diverticulitis, more complicated than we thought. J Gastrointest Surg. 2012;16(9):1744-1749.
30.    Broderick-Villa G, Burchette  RJ, Collins  JC, Abbas  MA, Haigh  PI.  Hospitalization for acute diverticulitis does not mandate routine elective colectomy. Arch Surg. 2005;140(6):576-581, discussion 581-583.
31.    Chapman  JR, Dozois  EJ, Wolff  BG, Gullerud  RE, Larson  DR.  Diverticulitis: a progres-sive disease? do multiple recurrences predict less favorable outcomes? Ann Surg. 2006;243(6):876-883.
32.    Eglinton  T, Nguyen  T, Raniga  S, Dixon  L, Dobbs  B, Frizelle  FA.  Patterns of recurrence in patients with acute diverticulitis. Br J Surg. 2010;97(6):952-957.
33.    Hall  JF, Roberts  PL, Ricciardi  R,  et al.  Long-term follow-up after an initial episode of diverticulitis: what are the predictors of recurrence? Dis Colon Rectum. 2011;54(3):283-288.
34.    Horgan  AF, McConnell  EJ, Wolff  BG, The  S, Paterson  C.  Atypical diverticular disease: surgical results. Dis Colon Rectum. 2001;44(9):1315-1318.
35.    Issa  N, Dreznik  Z, Dueck  DS,  et al.  Emergency surgery for complicated acute diverticulitis. Colorectal Dis. 2009;11(2):198-202
36.    Pittet  O, Kotzampassakis  N, Schmidt  S, Denys  A, Demartines  N, Calmes  JM. Recurrent left colonic diverticulitis episodes: more severe than the initial diverticulitis? World J Surg. 2009;33(3):547-552.
37.    Ritz  JP, Lehmann  KS, Frericks  B, Stroux  A, Buhr  HJ, Holmer  C.  Outcome of patients with acute sigmoid diverticulitis: multivariate analysis of risk factors for free perfora-tion. Surgery. 2011;149(5):606-613.
38.    Shaikh  S, Krukowski  ZH.  Outcome of a conservative policy for managing acute sigmoid diverticulitis. Br J Surg. 2007;94(7):876-879.
39.    Anaya  DA, Flum  DR.  Risk of emergency colectomy and colostomy in patients with diver-ticular disease. Arch Surg. 2005;140(7):681-685.
40.    Biondo  S, Parés  D, Martí Ragué  J, Kreisler  E, Fraccalvieri  D, Jaurrieta  E.  Acute colonic diverticulitis in patients under 50 years of age. Br J Surg. 2002;89(9):1137-1141.
41.    Biondo  S, Borao  JL, Kreisler  E,  et al.  Recurrence and virulence of colonic diverticulitis in immunocompromised patients. Am J Surg. 2012;204(2):172-179.
42.    Faria  GR, Almeida  AB, Moreira  H, Pinto-de-Sousa  J, Correia-da-Silva  P, Pimenta  AP.  Acute diverticulitis in younger patients: any rationale for a different approach? World J Gastroenterol. 2011;17(2):207-212.
43.    Guzzo  J, Hyman  N.  Diverticulitis in young patients: is resection after a single attack al-ways warranted? Dis Colon Rectum. 2004;47(7):1187-1190, discussion 1190-1191.
44.    Hjern  F, Josephson  T, Altman  D, Holmström  B, Johansson  C.  Outcome of younger patients with acute diverticulitis. Br J Surg. 2008;95(6):758-764.
45.    Klarenbeek  BR, Samuels  M, van der Wal  MA, van der Peet  DL, Meijerink  WJ, Cuesta  MA.  Indications for elective sigmoid resection in diverticular disease. Ann Surg. 2010;251(4):670-674.
46.    Kotzampassakis  N, Pittet  O, Schmidt  S, Denys  A, Demartines  N, Calmes  JM. Presenta-tion and treatment outcome of diverticulitis in younger adults: a different disease than in older patients? Dis Colon Rectum. 2010;53(3):333-338.
47.    Lahat  A, Menachem  Y, Avidan  B,  et al.  Diverticulitis in the young patient: is it differ-ent? World J Gastroenterol. 2006;12(18):2932-2935.
48.    Lopez-Borao  J, Kreisler  E, Millan  M,  et al.  Impact of age on recurrence and severity of left colonic diverticulitis. Colorectal Dis. 2012;14(7):e407-e412.
49.    Mäkelä  JT, Kiviniemi  HO, Laitinen  ST.  Acute sigmoid diverticulitis in young pa-tients. Hepatogastroenterology. 2009;56(94-95):1382-1387.
50.    Nelson  RS, Velasco  A, Mukesh  BN.  Management of diverticulitis in younger patients. Dis Colon Rectum. 2006;49(9):1341-1345.
51.    Ritz  JP, Lehmann  KS, Stroux  A, Buhr  HJ, Holmer  C.  Sigmoid diverticulitis in young patients: a more aggressive disease than in older patients? J Gastrointest Surg. 2011;15(4):667-674.
52.    Yoo  PS, Garg  R, Salamone  LF, Floch  MH, Rosenthal  R, Longo  WE.  Medical comorbidities predict the need for colectomy for complicated and recurrent diverticulitis. Am J Surg. 2008;196(5):710-714.
53.    Vermeulen  J, Coene  PP, Van Hout  NM,  et al.  Restoration of bowel continuity after sur-gery for acute perforated diverticulitis: should Hartmann’s procedure be considered a one-stage procedure? Colorectal Dis. 2009;11(6):619-624.
54.    Maggard  MA, Zingmond  D, O’Connell  JB, Ko  CY.  What proportion of patients with an ostomy (for diverticulitis) get reversed? Am Surg. 2004;70(10):928-931.
55.    Gawlick  U, Nirula  R.  Resection and primary anastomosis with proximal diversion instead of Hartmann’s: evolving the management of diverticulitis using NSQIP data. J Trauma Acute Care Surg. 2012;72(4):807-814, quiz 1124.
56.    Stumpf  MJ, Vinces  FY, Edwards  J.  Is primary anastomosis safe in the surgical manage-ment of complications of acute diverticulitis? Am Surg. 2007;73(8):787-790, discussion 790-791.
57.    Tabbara  M, Velmahos  GC, Butt  MU,  et al.  Missed opportunities for primary repair in complicated acute diverticulitis. Surgery. 2010;148(5):919-924.
58.    Trenti  L, Biondo  S, Golda  T,  et al.  Generalized peritonitis due to perforated diverticulitis: Hartmann’s procedure or primary anastomosis? Int J Colorectal Dis. 2011;26(3):377-384.
59.    Vermeulen  J, Akkersdijk  GP, Gosselink  MP,  et al.  Outcome after emergency surgery for acute perforated diverticulitis in 200 cases. Dig Surg. 2007;24(5):361-366.
60.    Oberkofler  CE, Rickenbacher  A, Raptis  DA,  et al.  A multicenter randomized clinical trial of primary anastomosis or Hartmann’s procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg. 2012;256(5):819-826, discussion 826-827.
61.    Karoui  M, Champault  A, Pautrat  K, Valleur  P, Cherqui  D, Champault  G.  Laparoscopic peritoneal lavage or primary anastomosis with defunctioning stoma for Hinchey 3 compli-cated diverticulitis: results of a comparative study. Dis Colon Rectum. 2009;52(4):609-615.
62.    Liang  S, Russek  K, Franklin  ME  Jr.  Damage control strategy for the management of perforated diverticulitis with generalized peritonitis: laparoscopic lavage and drainage vs laparoscopic Hartmann’s procedure. Surg Endosc. 2012;26(10):2835-2842
63.    Myers  E, Hurley  M, O’Sullivan  GC, Kavanagh  D, Wilson  I, Winter  DC.  Laparoscopic peritoneal lavage for generalized peritonitis due to perforated diverticulitis. Br J Surg. 2008;95(1):97-101.
64.    Rogers  AC, Collins  D, O’Sullivan  GC, Winter  DC.  Laparoscopic lavage for perforated diverticulitis: a population analysis. Dis Colon Rectum. 2012;55(9):932-938.
65.    White  SI, Frenkiel  B, Martin  PJ.  A ten-year audit of perforated sigmoid diverticulitis: high-lighting the outcomes of laparoscopic lavage. Dis Colon Rectum. 2010;53(11):1537-1541.
66.    Franklin  ME  Jr, Portillo  G, Treviño  JM, Gonzalez  JJ, Glass  JL.  Long-term experience with the laparoscopic approach to perforated diverticulitis plus generalized peritonitis. World J Surg. 2008;32(7):1507-1511.
67.    Antolovic  D, Reissfelder  C, Koch  M,  et al.  Surgical treatment of sigmoid diverticulitis: analysis of predictive risk factors for postoperative infections, surgical complications, and mortality. Int J Colorectal Dis. 2009;24(5):577-584.
68.    Ince  M, Stocchi  L, Khomvilai  S, Kwon  DS, Hammel  JP, Kiran  RP.  Morbidity and mortality of the Hartmann procedure for diverticular disease over 18 years in a single institution. Colorectal Dis. 2012;14(8):e492-e498.
69.    Larson  DW, Batdorf  NJ, Touzios  JG,  et al.  A fast-track recovery protocol improves outcomes in elective laparoscopic colectomy for diverticulitis. J Am Coll Surg. 2010;211(4):485-489.
70.    Lidor  AO, Schneider  E, Segal  J, Yu  Q, Feinberg  R, Wu  AW.  Elective surgery for diver-ticulitis is associated with high risk of intestinal diversion and hospital readmission in older adults. J Gastrointest Surg. 2010;14(12):1867-1873, discussion 1873-1874.
71.    Lidsky  ME, Thacker  JK, Lagoo-Deenadayalan  SA, Scarborough  JE.  Advanced age is an independent predictor for increased morbidity and mortality after emergent surgery for diverticulitis. Surgery. 2012;152(3):465-472.
72.    Morks  AN, Klarenbeek  BR, Flikweert  ER,  et al.  Current surgical treatment of diverticular disease in the Netherlands. World J Gastroenterol. 2010;16(14):1742-1746.
73.    Pendlimari  R, Touzios  JG, Azodo  IA,  et al.  Short-term outcomes after elective minimally invasive colectomy for diverticulitis. Br J Surg. 2011;98(3):431-435.
74.    Sheer  AJ, Heckman  JE, Schneider  EB,  et al.  Congestive heart failure and chronic ob-structive pulmonary disease predict poor surgical outcomes in older adults undergoing elective diverticulitis surgery. Dis Colon Rectum. 2011;54(11):1430-1437.
75.    Andeweg  C, Peters  J, Bleichrodt  R, van Goor  H.  Incidence and risk factors of recurrence after surgery for pathology-proven diverticular disease. World J Surg. 2008;32(7):1501-1506.
76.    Binda  GA, Arezzo  A, Serventi  A,  et al; Italian Study Group on Complicated Diverticulosis (GISDIC).  Multicentre observational study of the natural history of left-sided acute diverticulitis. Br J Surg. 2012;99(2):276-285.
77.    Thaler  K, Weiss  EG, Nogueras  JJ, Arnaud  JP, Wexner  SD, Bergamaschi  R. Recurrence rates at minimum 5-year follow-up: laparoscopic versus open sigmoid resection for uncom-plicated diverticulitis. Surg Laparosc Endosc Percutan Tech. 2003;13(5):325-327.
78.    Ambrosetti  P, Francis  K, Weintraub  D, Weintraub  J.  Functional results following elective laparoscopic sigmoidectomy after CT-proven diagnosis of acute diverticulitis evaluation of 43 patients and review of the literature. J Gastrointest Surg. 2007;11(6):767-772.
79.    Pasternak  I, Wiedemann  N, Basilicata  G, Melcher  GA.  Gastrointestinal quality of life after laparoscopic-assisted sigmoidectomy for diverticular disease. Int J Colorectal Dis. 2012;27(6):781-787.
80.    Levack  MM, Savitt  LR, Berger  DL,  et al.  Sigmoidectomy syndrome? patients’ perspec-tives on the functional outcomes following surgery for diverticulitis. Dis Colon Rectum. 2012;55(1):10-17.
81.    Forgione  A, Leroy  J, Cahill  RA,  et al.  Prospective evaluation of functional outcome after laparoscopic sigmoid colectomy. Ann Surg. 2009;249(2):218-224.
82.    Käser  SA, Glauser  PM, Basilicata  G, Müller  DA, Maurer  CA.  Timing of rectosigmoid resection for diverticular disease: the patient’s view. Colorectal Dis. 2012;14(3):e111-e116.
83.    Roberts  P, Abel  M, Rosen  L,  et al; Standards Task Force, American Society of Colon and Rectal Surgeons.  Practice parameters for sigmoid diverticulitis. Dis Colon Rectum. 1995;38(2):125-132
84.    Parks  TG, Connell  AM.  The outcome in 455 patients admitted for treatment of diverticular disease of the colon. Br J Surg. 1970;57(10):775-778.
85.    Oomen  JL, Engel  AF, Cuesta  MA.  Mortality after acute surgery for complications of diverticular disease of the sigmoid colon is almost exclusively due to patient related fac-tors. Colorectal Dis. 2006;8(2):112-119.
86.    Wolff  BG, Boostrom  SY.  Prophylactic resection, uncomplicated diverticulitis, and recurrent diverticulitis. Dig Dis. 2012;30(1):108-113.
87.    Klarenbeek  BR, Veenhof  AA, Bergamaschi  R,  et al.  Laparoscopic sigmoid resection for diverticulitis decreases major morbidity rates: a randomized control trial: short-term results of the Sigma Trial. Ann Surg. 2009;249(1):39-44.
88.    Klarenbeek  BR, Bergamaschi  R, Veenhof  AA,  et al.  Laparoscopic versus open sigmoid resection for diverticular disease: follow-up assessment of the randomized control Sigma trial. Surg Endosc. 2011;25(4):1121-1126
89.    Gervaz  P, Inan  I, Perneger  T, Schiffer  E, Morel  P.  A prospective, randomized, single-blind comparison of laparoscopic versus open sigmoid colectomy for diverticulitis. Ann Surg. 2010;252(1):3-8.
90.    Gervaz  P, Mugnier-Konrad  B, Morel  P, Huber  O, Inan  I.  Laparoscopic versus open sig-moid resection for diverticulitis: long-term results of a prospective, randomized trial. Surg Endosc. 2011;25(10):3373-3378.
91.    Raue  W, Paolucci  V, Asperger  W, Albrecht  R, Büchler  MW, Schwenk  W; LAPDIV-CAMIC Trial Group.  Laparoscopic sigmoid resection for diverticular disease has no ad-vantages over open approach: midterm results of a randomized controlled tri-al. Langenbecks Arch Surg. 2011;396(7):973-980.
92.    Raue  W, Langelotz  C, Paolucci  V,  et al.  Problems of randomization to open or laparo-scopic sigmoidectomy for diverticular disease. Int J Colorectal Dis. 2011;26(3):369-375.
93.    Zingg  U, Pasternak  I, Dietrich  M, Seifert  B, Oertli  D, Metzger  U.  Primary anastomosis vs Hartmann’s procedure in patients undergoing emergency left colectomy for perforated diverticulitis. Colorectal Dis. 2010;12(1):54-60.
94.    Thaler  K, Baig  MK, Berho  M,  et al.  Determinants of recurrence after sigmoid resection for uncomplicated diverticulitis. Dis Colon Rectum. 2003;46(3):385-388.
95.    O’Leary  DP, Myers  E.  Laparoscopic lavage for perforated diverticulitis: a panacea? Dis Colon Rectum. 2013;56(3):385-387. doi:10.1097/DCR.0b013e31827a750c.
96.    Swank  HA, Vermeulen  J, Lange  JF,  et al; Dutch Diverticular Disease (3D) Collaborative Study Group.  The ladies trial: laparoscopic peritoneal lavage or resection for purulent peri-tonitis and Hartmann’s procedure or resection with primary anastomosis for purulent or fae-cal peritonitis in perforated diverticulitis (NTR2037). BMC Surg. 2010;10:29.
97.    Thornell  A, Angenete  E, Gonzales  E,  et al; Scandinavian Surgical Outcomes Research Group (SSORG).  Treatment of acute diverticulitis laparoscopic lavage vs resection (DILA-LA): study protocol for a randomised controlled trial. Trials. 2011;12:186.
98.    Salem  L, Veenstra  DL, Sullivan  SD, Flum  DR.  The timing of elective colectomy in diver-ticulitis: a decision analysis. J Am Coll Surg. 2004;199(6):904-912.
99.    Daniels  L, de Korte  N, Winter  D, Boermeester  MA, Stockmann  HB.  Overtreatment of sigmoid diverticulitis: plea for a less aggressive approach. Dig Dis. 2012;30(1):86-91.
100.    Lau  KC, Spilsbury  K, Farooque  Y,  et al.  Is colonoscopy still mandatory after a CT diagnosis of left-sided diverticulitis: can colorectal cancer be confidently excluded? Dis Colon Rectum. 2011;54(10):1265-1270.
101.    Lahat  A, Yanai  H, Sakhnini  E, Menachem  Y, Bar-Meir  S.  Role of colonoscopy in patients with persistent acute diverticulitis. World J Gastroenterol. 2008;14(17):2763-2766.
102.    Bar-Meir  S, Lahat  A, Melzer  E.  Role of endoscopy in patients with diverticular dis-ease. Dig Dis. 2012;30(1):60-63.
103.    Lam  TJ, Meurs-Szojda  MM, Gundlach  L,  et al.  There is no increased risk for colorec-tal cancer and adenomas in patients with diverticulitis: a retrospective longitudinal study. Colorectal Dis. 2010;12(11):1122-1126.
104.    Schmilovitz-Weiss  H, Yalunin  E, Boaz  M,  et al.  Does a colonoscopy after acute diverticulitis affect its management? a single center experience. J Clin Gastroenterol. 2012;46(4):317-320.
105.    Westwood  DA, Eglinton  TW, Frizelle  FA.  Routine colonoscopy following acute un-complicated diverticulitis. Br J Surg. 2011;98(11):1630-1634.
106.    Fozard  JB, Armitage  NC, Schofield  JB, Jones  OM; Association of Coloproctology of Great Britain and Ireland.  ACPGBI position statement on elective resection for diverticulitis. Colorectal Dis. 2011;13(suppl 3):1-11.
107.    Peppercorn  MA.  The overlap of inflammatory bowel disease and diverticular disease. J Clin Gastroenterol. 2004;38(5)(suppl 1):S8-S10
 

 

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