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What paradigm shifts occurred in the management of acute diverticulitis during the COVID-19 pandemic?A scoping review

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World Journal of Clinical Cases 2021年第23期9卷 6759-6767页

作者： Gaetano Gallo Monica Ortenzi Ugo Grossi gian luca di tanna Francesco Pata Mario Guerrieri Giuseppe Sammarco Salomone di Saverio Department of Medical and Surgical Sciences University of CatanzaroCatanzaro 88011Italy Department of General and Emergency Surgery Polytechnic University of MarcheAncona 60121Italy 2^(nd)Surgery Unit Regional Hospital TrevisoDISCOGUniversity of PaduaTreviso 31100Italy The George Institute for Global Health University of New South WalesSydney 2050NSWAustralia Department of General Surgery Ospedale Nicola GiannettasioCorigliano-Rossano 87064Italy La Sapienza University Roma 00185Italy Department of General Surgery University of InsubriaUniversity Hospital of VareseVarese 21100Italy

BACKGROUND Acute colonic diverticulitis(ACD)is common in Western countries,with its prevalence increasing throughout the *** a result of the coronavirus disease 2019(COVID-19),elective surgery and in-patients’visits have been cancelled or postponed *** To systematically explore the impact of the pandemic in the management of *** MEDLINE,Embase,Scopus,MedxRiv,and the Cochrane Library databases were searched to 22 December *** which reported on the management of patients with ACD during the COVID-19 pandemic were *** cross sectional studies,outcomes of interest included the number of hospital admission for ACD,as well as key features of disease severity(complicated or not)across two time periods(pre-and during lockdown).RESULTS A total of 69 papers were inspected,and 21 were eligible for *** papers were cross sectional studies from seven world countries;six were case reports;three were qualitative studies,and two review articles.A 56%overall decrease in admissions for ACD was observed during lockdown,peaking 67%in the largest series.A 4%-8%decrease in the rate of uncomplicated diverticulitis was also noted during the lockdown *** initial non-operative management was recommended for complicated diverticulitis,and encouraged to an out-of-hospital *** initial concerns on the use of laparoscopy for Hinchey 3 and 4 patients to avoid aerosolized contamination,societal bodies have progressively mitigated their initial recommendations as actual risks are yet to be *** During the COVID-19 pandemic,fewer patients presented and were diagnosed with *** decline may have likely affected the spectrum of uncomplicated *** outpatient management and follow up for selected cases may unburden healthcare resources in time of crisis.

关键词： COVID-19 SARS-CoV-2 Acute diverticulitis diverticular disease Hartmann

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