The American Society of Colon and Rectal Surgeons Clinical ...

1 Downloadedfrom C33fy907 TbIFyHx640yafcu/EMfLBj0ena7lfLfVXefdPtD2 mEHxq/BpP2kvObheZQ/k1t9qDSwPpsO8 GTaUdiwuQjK1pQWMb33hySnFF8 XYif3Wu1+aLfG/RwOoqepMVfjbRG/tpOg=on 05/30/2020 Downloadedfrom C33fy907 TbIFyHx640yafcu/EMfLBj0ena7lfLfVXefdPtD2 mEHxq/BpP2kvObheZQ/k1t9qDSwPpsO8 GTaUdiwuQjK1pQWMb33hySnFF8 XYif3Wu1+aLfG/RwOoqepMVfjbRG/tpOg=on 05/30/2020728 DISEASES OF THE Colon & RECTUM VOLUME 63: 6 (2020)The American Society of Colon and Rectal Surgeons (ASCRS) is dedicated to ensuring high-quality pa-tient care by advancing the science, prevention, and management of disorders and diseases of the Colon , rectum, and anus.

2 The Clinical Practice guidelines Com-mittee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of Colon and Rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the Colon , rectum, and anus and develop Clinical practice guidelines based on the best a-vailable evidence. While not proscriptive, these guidelines provide information on which decisions can be made and do not dictate a specific form of treatment.

3 These guide-lines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines should not be deemed inclusive of all proper methods of care or exclu-sive of methods of care reasonably directed toward obtain-ing the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all the circumstances presented by the individual guidelines are constructed on the platform of the previously published Practice Parameters for the Treatment of Sigmoid diverticulitis published by the American Society of Colon and Rectal Surgeons (AS-CRS)

4 In A systematic search was conducted un-der the guidance of an information services librarian. This search strategy is outlined under the search ap-pendices (see Supplemental Digital Content, ). The PubMed, EMBASE, Cochrane, and Web of Science databases were searched from January 1, 2013, until October 26, 2019. Relevant manuscripts identified by individual authors were also included. Key word combinations using the MeSH terms including diverticulitis , Diverticulosis, Diverticu-lar, Colonic, Colon Diverticulosis, Surgery, Med-ical Therapy, Antibiotics, Probiotics, Laparoscopic Lavage, Mesalamine, Rifaximin, and Surgery were performed.

5 The search was limited to English language abstracts with human subjects. A directed search of ref-Earn Continuing Education (CME) credit online at Supplemental digital content is available for this article. Direct URL ci-tations appear in the printed text, and links to the digital files are pro-vided in the HTML and PDF versions of this article on the journal s Web site ( ).Funding/Support: None Disclosures: None : Daniel L. Feingold, , Professor and Chair, Section of Colorectal Surgery, Rutgers University, New Brunswick, American Society of Colon and Rectal Surgeons Clinical Practice guidelines for the Treatment of Left-Sided Colonic DiverticulitisJason Hall, , Karin Hardiman, , Sang Lee, Amy Lightner, Luca Stocchi, Ian M.

6 Paquette, Scott R. Steele, , Daniel L. Feingold, Prepared on behalf of the Clinical Practice guidelines Committee of the American Society of Colon and Rectal Surgeons1 Section of Colon and Rectal Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts2 Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, Alabama3 Division of Colon and Rectal Surgery, USC Keck School of Medicine, Los Angeles, California4 Department of Colorectal Surgery, Cleveland Clinic Cleveland.

7 Cleveland, Ohio5 Division of Colorectal Surgery, Mayo Clinic Florida, Jacksonville, Florida6 Division of Colon and Rectal Surgery, University of Cincinnati, Cincinnati, Ohio7 Section of Colorectal Surgery, Rutgers University, New Brunswick, New JerseyDis Colon Rectum 2020; 63: 728 747 DOI: The ASCRS 2020 Clinical PRACTICE GUIDELINESDISEASES OF THE Colon & RECTUM VOLUME 63: 6 (2020)729erences embedded in the candidate publications was also performed. Emphasis was placed on prospective trials, meta-analyses, systematic reviews, and practice guidelines .

8 Peer-reviewed observational studies and ret-rospective studies were included when higher-quality evidence was insufficient. In brief, a total of 4885 unique journal titles were identified. Initial review of the search results led to the exclusion of 4223 titles based on irrel-evance of the title or because they consisted of a case report, letter to the editor, or nonsystematic review. A review of the remaining 662 titles included assessment of the full-length articles.

9 This led to exclusion of an additional 494 titles for which similar but higher-level evidence was available. The remaining 168 titles were considered for grading of the recommendations (Fig. 1). The final source material used was evaluated for the methodological quality, the evidence base was exam-ined, and a treatment guideline was formulated by the subcommittee for this guideline. The final grade of rec-ommendation and level of evidence for each statement were determined using the Grades of Recommendation, Assessment, Development, and Evaluation system (Ta-ble 1).

10 2 When agreement was incomplete regarding the evidence base or treatment guideline, consensus from the committee chair, vice chair, and 2 assigned review-ers determined the outcome. Members of the ASCRS Clinical Practice guidelines Committee worked in joint production of these guidelines from inception to pub-lication. Recommendations formulated by the subcom-mittee were reviewed by the entire Clinical Practice guidelines Committee. The submission was peer-re-viewed by Diseases of the Colon & Rectum and the final recommendations were approved by the ASCRS Execu-tive Council.