Evidence map›Paper›PMID 42684446›Full record

SynthesisSurgical endoscopy2026

Systematic review and meta-analysis on key controversies in the management of diverticular disease: a multi-society collaboration.

Bright Huo, Justin Dourado, Maher Al Khaldi, Iro Ntaga, Joe Broderick, Dena Shehata, Elisa Calabrese, Gita Lingam, Anse de Sadeleer, Elizabeth Barbera and 25 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors.

Bright HuoDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada. brighthuo@dal.ca.ORCID http://orcid.org/0000-0003-4999-4328
Justin DouradoDepartment of Colon and Rectal Surgery, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Maher Al KhaldiDepartment of Colon and Rectal Surgery, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Iro NtagaDepartment of Primary Education, University of Ioannina, Ioannina, Greece.
Joe BroderickDepartment of Surgery, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
Dena ShehataDepartment of Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA.
Elisa CalabreseDepartment of Surgery, University of California-East Bay, Oakland, CA, USA.
Gita LingamSt Mark's National Bowel Hospital, London, UK.
Anse de SadeleerDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Elizabeth BarberaDepartment of Surgery, RAF Lakenheath Hospital, Brandon, UK.
Caroline ReinkeWake Forest School of Medicine; Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA.
Francesco CarranoDivision of General and Emergency Surgery, Sant' Andrea Hospital, Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.
Stephanie BreukinkDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Andreas KaiserDivision of Colorectal Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Irene MarafiniPoliclinico Tor Vergata, UOC Gastroenterologia, Rome, Italy.
Walter BifflDepartment of Surgery, Scripps Clinic/Scripps Clinic Medical Group, La Jolla, CA, USA.
Fausto CatenaDept of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Frank FrizelleDepartment of Surgery and Critical Care, University of Otago, Christchurch, New Zealand.
Triantafyllos DouliasDepartment of Colorectal Surgery, Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK.
Antonio TursiTerritorial Gastroenterology Service, Barletta-Andria-Trani (BAT) Local Health Agency, Andria, Italy.
James KimblePatient Partner, New York, NY, USA.
Nicole BuchenholzPatient Partner, New York, NY, USA.
Sophie WallsPatient Partner, New York, NY, USA.
Xiaomei YaoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Gordon GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Marina YiasemidouDepartment of Colorectal Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK.
Danique HeuvelingsDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Richard GarfinkleDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Maria Abou-KhalilDivision of General Surgery, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada.
Bethany J SlaterDepartment of Surgery, Mount Sinai Kravis Children's Hospital, New York, NY, USA.
Stavros A AntoniouDepartment of Surgery, Papageorgiou General Hospital, Thessaloniki, Greece.
Nicole BouvyNUTRIM, Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.
Patricia SyllaDivision of Colon and Rectal Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Nader FrancisThe Griffin Institute, Northwick Park and St Mark's Hospital, Harrow, UK.
Marylise BoutrosDepartment of Colon and Rectal Surgery, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe performed a systematic review & meta-analysis to inform the development of a multi-society guideline on the management of diverticular disease.

methodsWe identified randomized trials and cohort studies addressing five key questions for patients with symptomatic uncomplicated diverticular disease (SUDD), uncomplicated diverticulitis, and complicated diverticulitis. Our panel established outcomes and decision thresholds. Two reviewers performed screening by title and abstract and full-text, data extraction, and risk of bias appraisal. We applied a random-effects meta-analysis and appraised the certainty of the evidence per GRADE.

resultsWe identified 27 studies from 5,449 articles. For KQ3, patients with recurrent symptomatic uncomplicated diverticulitis experienced an improvement in quality of life at 2 years [standardized mean difference of 0.53, 95% CI (0.30-0.76), clinically significant effect, low certainty] and a reduced rate of disease recurrence at 1 year [286 fewer per 1,000, 95% CI (350 fewer to 124 fewer), large effect, low certainty] with elective surgery vs. surveillance. For KQ4, when compared to a traditional screening cohort, patients with an initial episode of uncomplicated diverticulitis undergoing colonoscopy did not have a significantly different rate of detecting advanced adenomas [37 more per 1,000, 95% CI (18 more to 60 more), trivial effect, low certainty] and uncertainty in the impact on detecting colorectal cancers [1 more per 1,000, 95% CI (2 fewer to 7 more), trivial effect, very low certainty]. For KQ5, patients with diverticulitis complicated by an abscess experienced a reduction in recurrence at 1 year [198 fewer per 1,000, 95% CI (206 fewer to 186 fewer), small effect, moderate certainty] and no difference in 30-day mortality [10 more per 1,000, 95% CI (0 fewer to 68 more), trivial effect, moderate certainty] with elective surgery vs. surveillance.

conclusionThis systematic review illustrates contemporary evidence and research gaps in the management of patients with diverticular disease.

Indexed as

Diverticular DiseasesHumansPractice Guidelines as TopicQuality of LifeRecurrenceColorectal surgeryDiverticulitisGuidelinesLaparoscopic surgeryMinimally invasive surgerySUDDSystematic review

Identifiers

PMID42684446

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.