Diverticulitis, surgery, evidence-based medicine, and the Steve Jobs' dots: a narrative review. (2024)

Afiliação

• Agresta F; Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy.
• Montori G; Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy. giulia.montori@gmail.com.
• Podda M; Department of Surgical Science, University of Cagliari, Cagliari, Italy.
• Ortenzi M; Clinica di Chirurgia Generale e d'Urgenza, Università Politecnica delle Marche, Ancona, Italy.
• Giordano A; Surgery Department, Emergency Surgery Unit, Careggi University Hospital, Florence, Italy.
• Bergamini C; Surgery Department, Emergency Surgery Unit, Careggi University Hospital, Florence, Italy.
• Mazzarolo G; Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy.
• Licitra E; Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy.
• Gobbi T; Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy.
• Procida G; Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy.
• Borgo AD; Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy.
• Botteri E; ASST Spedali Civili Brescia, P.O. Montichiari, Brescia, Italy.
• Ansaloni L; Unit of General Surgery I, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
• Fugazzola P; Unit of General Surgery I, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
• Savino G; Unit of General and Emergency Surgery, Vittorio Veneto Hospital, Via C. Forlanini 71, 31029, Vittorio Veneto, TV, Italy.
• Guerrieri M; Clinica di Chirurgia Generale e d'Urgenza, Università Politecnica delle Marche, Ancona, Italy.
• Campanile FC; Director of Surgery, Ospedale San Giovanni Decollato Andosilla, ASL, VT, Italy.
• Sartori A; Department of General Surgery, Ospedale di Montebelluna, Montebelluna, Italy.
• Petz W; Division of Digestive Surgery, IEO European Institute of Oncology IRCCS, 20141, Milan, Italy.
• Silecchia G; Department of Medico-Surgical Sciences and Biotechnologies, University La Sapienza of Rome, Latina, Italy.
• di Saverio S; Department of General Surgery, ASUR Marche, AV5, Hospital of San Benedetto del Tronto, San Benedetto del Tronto, Italy.
• Catena F; Department of Surgery, "Bufalini" Hospital, Cesena, Italy.
• Agrusa A; Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.
• Salemi M; Medical Director of ULSS 2Trevigiana, Vittorio Veneto Hospital, Vittorio Veneto, TV, Italy.
• Morales-Conde S; University Hospital Virgen del Rocío, Seville, Spain.
• Arezzo A; Department of Surgical Sciences, University of Torino, Torino, Italy.

ABSTRACT

PURPOSE:

Emergency treatment of acute diverticulitis remains a hazy field. Despite a number of clinical studies, randomized controlled trials (RCTs), guidelines and surgical societies recommendations, the most critical hot topics have yet to be addressed.

METHODS:

Literature research from 1963 until today was performed. Data regarding the principal RCTs and observational studies were summarized in descriptive tables. In particular we aimed to focus on the following topics the role of laparoscopy, the acute care setting, the RCTs, guidelines, observational studies and classifications proposed by literature, the problem in case of a pandemic, and the importance of adapting treatment /place/surgeon conditions.

RESULTS:

In the evaluation of these points we did not try to find any prospective evolution of the concepts achievements. On the contrary we simply report the individuals strands of research from a retrospective point of view, similarly to what Steve Jobes said "you can't connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future". We have finally obtained what can be defined "a narrative review of the literature on diverticulitis".

CONCLUSIONS:

Not only evidence-based medicine but also the contextualization, as also the role of 'competent' surgeons, should guide to novel approach in acute diverticulitis management.