Submited on: 08 Jul 2013 08:27:32 PM GMT
Published on: 09 Jul 2013 05:31:10 AM GMT
 

  • What are the main claims of the paper and how important are they?

    To clarify which surgical techniques is better, RT or NRT, in patients with acute colonic diverclar perforation.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    No; there is so big bias between RT and NRT groups. The author should describe the selection criteria between RT and NRT and should


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No comments


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    No; there is so big bias between RT and NRT groups


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Yes; the authors should describe the selection criteria between RT and NRT.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No


  • Other Comments:

    No

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Japanese Journal

  • Experience and credentials in the specific area of science:

    NA

  • How to cite:  Moriwaki Y .Indications and Surgical Techniques In the Treatment of Complicated Acute Diverticulitis. Retrospective Study of a 13 Year Old case History[Review of the article 'Indications and Surgical Techniques In the Treatment of Complicated Acute Diverticulitis. Retrospective Study of a 13 Year Old case History ' by Italia S].WebmedCentral 2013;4(8):WMCRW002824
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  • What are the main claims of the paper and how important are they?

    The study aims to dtermine which surgical technique will achieve the best results for "acute complicated diverticulitis" namely non-resective surgical techniques (laparoscopic or open surgery, NRT) and resection treatment (RT) with further subcategorization as resection and primary anastomosis (PRA) or traditional Hartmann's procedure.

    The authors claim that:

    1. Resection with primary anastomosis procedure as single step can be performed safely in patients with Hinchey Stage II / III peritonitis in the presence of favorable criteria.
    2. Hartmann's procedure remains the treatment of choice in patients with Hinchey stage III / IV peritonitis, severe sepsis, septic shock with MOF, poor functional reserve, immunosuppression and hemodynamic instability.
    3. Non-resection therapy (washing and laparoscopic drainage) should be considered in patients with a low degree of peritoneal contamination or failure of percutaneous drainage or Hinchey Stage III peritonitis. However, this method should be considered only in selected patients (younger and in good condition and hemodynamically stable).


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    The claims are not novel. The studies addressing the topic include:

    1. Cirocchi R, Trastulli S, Desiderio J, Listorti C, Boselli C, Parisi A, Noya G, Liu L. Treatment of Hinchey stage III-IV diverticulitis: a systematic review and meta-analysis. Int J Colorectal Dis. 2013 Apr;28(4):447-57. doi: 10.1007/s00384-012-1622-4. Epub 2012 Dec 15.
    2. Swank HA, Mulder IM, Hoofwijk AG, Nienhuijs SW, Lange JF, Bemelman WA; Dutch Diverticular Disease Collaborative Study Group. Early experience with laparoscopic lavage for perforated diverticulitis. Br J Surg. 2013 Apr;100(5):704-10. doi: 10.1002/bjs.9063. Epub 2013 Feb 12.
    3. Oberkofler CE, Rickenbacher A, Raptis DA, Lehmann K, Villiger P, Buchli C, Grieder F, Gelpke H, Decurtins M, Tempia-Caliera AA, Demartines N, Hahnloser D, Clavien PA, Breitenstein S. A multicenter randomized clinical trial of primary anastomosis or Hartmann's procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg. 2012 Nov;256(5):819-26; discussion 826-7. doi: 10.1097/SLA.0b013e31827324ba.


  • Are the claims properly placed in the context of the previous literature?

    The discussion is sketchy and does not adress the previously published literature in detail


  • Do the results support the claims? If not, what other evidence is required?

    Yes the results support the cliam


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Not applicable


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Multicentre, randomized trials are required to address the issue


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No.

    The topic and claims is not novel

    Retrospective study

    Discussion is sketchy


  • Other Comments:

    None

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Routine operate on patients with complicated diverticular disease

  • How to cite:  Anonymous.Indications and Surgical Techniques In the Treatment of Complicated Acute Diverticulitis. Retrospective Study of a 13 Year Old case History[Review of the article 'Indications and Surgical Techniques In the Treatment of Complicated Acute Diverticulitis. Retrospective Study of a 13 Year Old case History ' by Italia S].WebmedCentral 2013;4(8):WMCRW002821
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  • What are the main claims of the paper and how important are they?

    To study indications & techniques in treatment of complicated acute diverticulitis


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Yes


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    I would like to put following points about this case study-

    1. Acute complicated diverticulitis can have three presentations- a) perforation b) obstruction c) haemorrhage
    2. In this paper only perforations have taken into consideration -why?
    3. Then the title should have been revised accordingly
    4. The discussion should have been more thorough
    5. No emphasis of colostomy has been mentioned in discussion
    6. Patient counselling is also very important- not mentioned at all
    7. Which procedure is cost effective & time tested?
    8. References could have been more


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No


  • Other Comments:

    No

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I am working as gastro-intestinal surgeon for last 14 years where i have encountered similar situations.

  • How to cite:  Belekar D M.Indications & surgical techniques in the treatment of complicated acute diverticulitis: retrospective study of a 13 years old case history[Review of the article 'Indications and Surgical Techniques In the Treatment of Complicated Acute Diverticulitis. Retrospective Study of a 13 Year Old case History ' by Italia S].WebmedCentral 2013;4(7):WMCRW002787
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