Table 1 The detailed information of the included studies
Author | Design* | period | brief conclusion |
|---|---|---|---|
Right-sided diverticulitis | |||
Mizuki et al. [17] | RCS | 1998–2009 | The rate of recurrence did not differ between left-sided and right-sided diverticulitis (20% vs 27%, p = NS*) |
Chen et al. [21] | RCS | 2013–2020 | Right-sided diverticulitis with non-operative treatment had a low recurrence rate (2%) |
Moon et al. [22] | RCS | 2001–2005 | Conservative treatment should be considered a safe and effective option for acute right-sided diverticulitis as its low rate of recurrence (3.6%) and treatment failure (0%) |
Issa et al. [23] | RCS | 2005–2007 | The current study supports conservative therapy for right-sided diverticulitis due to a low recurrence rate (7%) and treatment failure rate (0%) |
Ha et al. [24] | RCS | 2005–2012 | Conservative treatment had a low recurrence rate (10%) in patients with acute right-sided diverticulitis |
Park et al. [25] | RCS | 1998–2007 | Conservative treatment is primarily required for right-sided diverticulitis, and the recurrence rate was 8%. The rate of treatment failure was 1% |
Kim et al. [26] | RCS | 2008–2009 | Conservative treatment with antibiotics should be the treatment of choice for right-sided diverticulitis which had a recurrence rate of 13% |
Park et al. [27] | PCS | 2007–2009 | Outpatient management for uncomplicated right-sided diverticulitis had a similar recurrence rate compared with inpatient management (10% vs 11%, p = NS*). No treatment failure was noted in both groups |
Park et al. [20] | PCS | 2004–2012 | The recurrence rate for medical treatment of right-sided diverticulitis was 19%; of those, diverticula located only in the right colon and a single diverticulum had a lower recurrence rate |
Park et al. [19] | RCS | 2017–2019 | In medical treatment for right-sided diverticulitis, 9% ended up with treatment failure. Elderly (Age > 50), recurrent episodes, and elevated C-reactive protein levels are factors associated with treatment failure. The recurrence rate was 13% in the conservative treatment success group |
Kim et al. [28] | RCT | 2014–2018 | The overall recurrence rate of medical treatment for right-sided diverticulitis was 9%. No significant differences were shown between the antibiotics and the non-antibiotics group in the recurrence rate (10% vs 8%, p = NS*) and the treatment failure rate (2% vs. 5%, p = NS*) |
Kim et al. [8] | RCS | 2001–2014 | The recurrence rate was 11% in right-sided diverticulitis. Smoking and longer hospital stay were the risk factors for recurrence |
Park et al. [9] | RCS | 2002–2012 | 16% of the included patients had a recurrence of right-sided diverticulitis. Multiple diverticula and intraperitoneally located diverticulitis may have a higher recurrence rate |
Courtot et al. [29] | RCS | 2003–2017 | The article consisted of western populations, right-sided diverticulitis had a recurrence rate of 10.4% and treatment failure rate of 6% |
Schneider et al. [30] | RCS | 2005–2013 | The recurrence rate of right-sided diverticulitis was 16.7%. In Caucasians, right-sided diverticulitis occurred in younger and thinner patients compared to left-sided |
Destek et al. [31] | RCS | 2014–2017 | The overall rate of recurrence was 21.1% in acute right-sided diverticulitis |
Lee et al. [18] | RCS | 2011–2017 | The recurrence rate of left-sided diverticulitis was higher than right-sided (19.1% vs 6.9%, p = 0.003). In addition, compared to left-sided, right-sided diverticulitis presented as younger age and less advanced modified Hinchey stages |
Matsushima et al. [32] | RCS | 1994–2005 | Conservative therapy had a low recurrence rate of 8.4% in acute right-sided diverticulitis |
Park et al. [33] | RCS | 2000–2007 | The overall recurrence rate was 2%. However, patients who had a pericolic abscess showed a high recurrence rate of 20% |
Park et al. [34] | RCT | 2011–2014 | No significant differences were shown between one-day versus four-day antibiotics treatment strategy in recurrence (10.3% vs 9.0%, p = NS*) and treatment failure (17.2% vs 21.3%, p = NS*) |
Yang et al. [35] | RCS | 1994–2004 | The recurrence rate of acute right-sided diverticulitis was 12.6%. For recurrent diseases, conservative treatment was still safe and efficient |
Left-sided diverticulitis | |||
Daniels et al. [36] | RCT | 2010–2014 | The recurrence rate was low (3% vs 3%, p = NS*) in both strategies with or without antibiotics within 6 months of follow-up. The rate of treatment failure was 7% and 11% in the antibiotics group and observation group respectively |
Pisanu et al. [8] | RCS | 2006–2011 | The rate of recurrence was similar (6% vs 20%, p = NS*) between the older and younger groups. No patient suffered from treatment failure under medical treatment in this study |
Mizuki et al. [17] | RCS | 1998–2009 | The rate of recurrence did not differ between left-sided and right-sided diverticulitis (20% vs 27%, p = NS*) |
Santos et al. [37] | RCT | 2018–2020 | Conservative treatment of complicated sigmoid diverticulitis had a high recurrence rate (27%) within 6 months |
Holmer et al. [38] | PCS | 2004–2007 | The rate of treatment failure was low (4%). However, conservative treatment had a much higher recurrence than the surgical intervention (33% vs 4%, p < 0.001) |
Mizrahi et al. [39] | RCS | 1998–2008 | Conservative treatment for sigmoid diverticulitis had a recurrence rate of 21%, but no emergent surgery was required during long-term follow-up |
Chabok et al. [40] | RCT | 2003–2010 | The rate of recurrence did not differ between antibiotics and non-antibiotics groups (16% vs 16%, p = NS*) in the treatment of left-sided diverticulitis. Also, the rate of treatment failure was similar between antibiotics and non-antibiotics groups (1% vs. 0.3%, p = NS*) |
Reisman et al. [42] | RCS | 1987–1997 | The rate of recurrence was 30%. No significant difference in recurrence was found between older (> 60 years) and younger (≤ 60 years) patients, whether treated conservatively or surgically |
Muller et al. [41] | RCS | 1985–1991 | Although the recurrence rate of sigmoid diverticulitis was reported high (47%), lethal complications were still rare. Also, the rate of treatment failure was 0% |
Frileux et al. [43] | RCS | 1995–2002 | The recurrence rate of sigmoid diverticulitis was high (43%), but recurrence attacks were rarely severe. Operative treatment was not advised after the first attack of diverticulitis |
Lopez-Borao et al. [44] | RCS | 1998–2008 | The overall recurrence rate of diverticulitis was 20.5%. The rate of treatment failure was 6.9%. Younger age (< 45 years) was not a risk of recurrence |
Binda et al. [45] | RCS | 1996–1999 | The rate of recurrence was higher in medical treatment than in operative treatment (17.2% vs 5.8%, p < 0.001). Risk factors for recurrence included medical treatment, younger age (< 40 years), and a history of at least 3 episodes of acute diverticulitis. In addition, the overall treatment failure rate was 6.9% |
Biondo et al. [46] | RCS | 1994–2008 | The rate of recurrence was 20.7%. No significant differences were shown between the immunosuppressed patients and the nonimmunosuppressed patients (21.5% vs 20.5%, p = NS*) |
Unlü et al. [47] | RCS | 2004–2012 | The recurrence rate of acute sigmoid diverticulitis was 24.4%. The younger group (≤ 50 years) was not associated with a higher recurrence rate than the older group (25.6% vs 23.8%, p = NS*) |
Buchs et al. [48] | PCS | 2007–2011 | The overall recurrence rate was 16.4% in uncomplicated sigmoid diverticulitis. A high level of serum C-reactive protein (> 240 mg/L) was associated with early recurrence (< 6 months) (p = NS*) |
Trenti et al. [49] | RCS | 1994–2011 | The recurrence rate of acute diverticulitis was 14.8% in this study. The univariate analysis showed higher recurrence in patients under chronic corticoid therapy (p = 0.043) and the presence of more than 1 abscess (p < 0.001) |
Brochmann et al. [50] | RCS | 2013–2014 | The recurrence rate of uncomplicated left-sided diverticulitis was 6.7%, and the treatment failure rate was 3.6%. No significant differences were shown between the patients treated with antibiotics and those without antibiotics (10.9% vs 4.6%, p = NS*) |
Lee et al. [18] | RCS | 2011–2017 | The recurrence rate of left-sided diverticulitis was higher than right-sided (19.1% vs 6.9%, p = 0.003). In addition, compared to left-sided, right-sided diverticulitis presented as younger age and less advanced modified Hinchey stages |
Meyer et al. [51] | RCS | 2005–2009 | In Hinchey 1a diverticulitis, the overall recurrence rate was 23.9%. The presence of extraluminal air on computed tomography did not show a higher recurrence rate (17.9% vs 25.3%, p = NS*) |