{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:48:02Z","timestamp":1791319682125,"version":"4.3.1"},"reference-count":45,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction\/Purpose<\/jats:title>\n                    <jats:p>Diverticulitis with abscess (Hinchey Ib or II) is often initially managed nonoperatively with antibiotics and\/or percutaneous drainage (PCD). For patients who respond successfully to this approach, it remains controversial whether an elective colectomy (EC) should routinely follow. This systematic review and meta-analysis evaluate and compare the outcomes of two strategies in this population: EC vs continued observation after successful nonoperative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library through August 15, 2024, for studies comparing EC to continued observation in patients with Hinchey Ib\/II diverticulitis who achieved initial successful nonoperative management. Outcomes assessed included recurrence of diverticulitis. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included four studies comprising 7236 patients. Among these, 1719 patients (24%) underwent EC following initial successful nonoperative treatment, while 5517 (76%) did not undergo elective surgery. The average patient age was 58.5\u00a0years, with a mean follow-up of 3.22\u00a0years. The mean time to EC ranged from 2 to 6\u00a0months. Elective colectomy was associated with a significantly lower recurrence rate (OR 0.14; 95% CI 0.11-0.17;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%) but a higher frequency of stoma formation (OR 1.83; 95% CI 1.51-2.23;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with Hinchey Ib or II diverticulitis who initially underwent successful nonoperative management, subsequent EC was associated with lower odds of recurrence but higher odds of stoma formation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>PROSPERO CRD42024582759.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261423926","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:05:31Z","timestamp":1773234331000},"page":"2078-2086","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Elective Colectomy Versus Observation Following Initial Nonoperative Success in Hinchey Ib\/II Diverticulitis: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"92","author":[{"given":"Fatemeh","family":"Akbarpoor","sequence":"first","affiliation":[{"name":"Mohammed Bin Rashid University of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7687-3073","authenticated-orcid":false,"given":"Lucas 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