UK National General Surgery Audit: Management of Acute Complicated Diverticulitis

In Projects by gregtaylor

Yorkshire Surgical Research Collaborative is delighted and greatly excited to have been selected by the National Surgical Research Collaborative to host the next national general surgery audit. 10 audit abstracts from collaboratives  around the UK were submitted and reviewed by an expert panel (Profs. Morton, Jayne and Blazeby). The abstracts were of high standard and across a diverse range of topics (see below), so there is much potential for continued national collaboration.

There is a large variation in the management of diverticulitis, not least in the acute phase, with no level 1 evidence to guide practice. When complicated by perforation or abscess, the options are for antibiotics, radiological drainage, laparoscopic washout or laparotomy +/- resection and stoma. Choice of strategy is multifactorial and depends upon: radiological evidence of contamination, presence of systemic sepsis, patient co-morbidities and also surgeons’ personal preference.

These factors, together with the high morbidity and mortality associated with complicated diverticulitis make treatment challenging in the clinical setting and randomisation difficult in clinical trials.  A national audit of practice in the UK will highlight where variation is most marked, identifying the most influential factors in clinical decision making as well as the most important questions for clinical trials.

The audit will be discussed in more detail at ASIT in Belfast 28th-30th March 2014. More information will also be posted here, as well as at www.ysrc.org.uk and on Twitter @YSRC_UK.

This year’s audit abstracts:
1 РACE IVT – Improving IV fluid prescribing
2 – Validation and Audit of Acute Pancreatitis scORe (VAPOR)
3 РAccuracy of documentation of pregnancy status in female general surgical admissions for emergency and elective procedures – is there a requirement for a national standard?
PRESS study (Pregnancy status in surgery)
4 – A prospective multicentre audit of post-operative readmissions in general surgery
5 – Post-operative fluid balance and adherence to the British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients (GIFTASUP)
6 – PERioperative Fluid in Elective ColecTomy (PERFECT) audit
7 – Gallstone Pancreatitis Management: A National Prospective Audit
8 – Audit of operation note documentation and clinical coding
9 – Management Considerations in Acute Pancreatitis: Fluid resuscitation
10 – A prospective audit of the diversity of management in acute complicated diverticulitis