IPOD Study: Management of Acute Left Colonic Diverticulitis in Italian Surgical Departments.
In recent years, the emergency management of acute left colonic diverticulitis (ALCD) has evolved dramatically despite lack of strong evidence. As a consequence, management strategies are frequently guided by surgeon's personal preference, rather than by scientific evidence. The primary aim of IPOD study (Italian Prospective Observational Diverticulitis study) is to describe both the diagnostic and treatment profiles of patients with ALCD in the Italian surgical departments.



IPOD study is a prospective observational study performed during a 6-month period (from April 1 2015 to September 1 2015) and including 89 Italian surgical departments. All consecutive patients with suspected clinical diagnosis of ALCD confirmed by imaging and seen by a surgeon were included in the study. The study was promoted by the Italian Society of Hospital Surgeons and the World Society of Emergency Surgery Italian chapter.



Eleven hundred and twenty-five patients with a median age of 62 years [interquartile range (IQR), 51-74] were enrolled in the IPOD study. One thousand and fifty-four (93.7%) patients were hospitalized with a median duration of hospitalization of 7 days (IQR 5-10). Eight hundred and twenty-eight patients (73.6%) underwent medical treatment alone, 13 patients had percutaneous drainage (1.2%), and the other 284 (25.2%) patients underwent surgery as first treatment. Among 121 patients having diffuse peritonitis, 71 (58.7%) underwent Hartmann's resection. However, the Hartmann's resection was used even in patients with lower stages of ALCD (36/479; 7.5%) where other treatment options could be more adequate.



The IPOD study demonstrates that in the Italian surgical departments treatment strategies for ALCD are often guided by the surgeon's personal preference.
Department of Surgery, Macerata Hospital, Macerata, Italy.
Massimo
M
Sartelli
Department of Surgery, Galliera Hospital, Genoa, Italy.
Gian Andrea
GA
Binda
Department of General Surgery, ULSS 3, Bassano Del Grappa (VI), Italy.
Francesco
F
Brandara
Department of General Surgery, Humanitas Gradenigo, Turin, Italy.
Andrea
A
Borasi
Department of Surgery, Santo Stefano Hospital, Prato, Italy.
Francesco
F
Feroci
Department of Surgery, Cannizzaro Hospital, Catania, Italy.
Salvatore
S
Vadalà
Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, UNIVPM, Ancona, Italy.
Francesco M
FM
Labricciosa
Department of General Surgery, University of Bologna, Bologna, Italy.
Arianna
A
Birindelli
Department of Surgery, Brotzu Hospital, Cagliari, Italy.
Gianluigi
G
Luridiana
Department of Surgery, Rimini Hospital, Rimini, Italy.
Federico
F
Coccolini
General Surgery, Emergency and Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy. salo75@inwind.it.
Salomone
S
Di Saverio
Department of Emergency Surgery, Maggiore Hospital, Parma, Italy.
Fausto
F
Catena
Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Luca
L
Ansaloni
Unit of General Surgery, AUSL VT, San Giovanni Decollato-Andosilla Hospital, Civita Castellana, Italy.
Fabio Cesare
FC
Campanile
Department of General Surgery, ULSS19 del Veneto, Adria, RO, Italy.
Ferdinando
F
Agresta
Department of Surgery, Vittorio Emanuele Hospital, Catania, Italy.
Diego
D
Piazza
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003082:Colectomy; D004239:Diverticulitis, Colonic / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004322:Drainage; D005260:Female; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology / Q000601:surgery*; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D013503:Surgery Department, Hospital
D000900:Anti-Bacterial Agents