Surgical treatment of diverticulitis and its complications: A systematic review and meta-analysis of randomized control trials.

PURPOSE: The surgical interventions of diverticulitis vary according to its grade and severity. There is a controversy about the best of these different surgical procedures. We aimed to systematically review and meta-analyze randomized controlled trials (RCTs) comparing outcomes and complications between different surgical approaches for acute diverticulitis and its complications. METHODS: Nine electronic databases including PubMed, Scopus, and Web of Science were searched for RCTs comparing different surgical procedures for different grades of diverticulitis. The risk of bias was assessed using the Cochrane Collaboration tool. The protocol was registered in PROSPERO (CRD42015032290). RESULTS: Outcome data were analyzed from five RCTs comparing laparoscopic sigmoid resection (LSR) (n = 247) versus open sigmoid resection (OSR) (n = 237) for treatment of acute complicated diverticulitis with minimal heterogeneity. There was no significant difference in short-term postoperative overall morbidity (risk ratio (RR) 0.89, 95% confidence interval (CI) 0.61-1.31; P = 0.56) and long-term postoperative major morbidity (RR 0.78, 95% CI 0.46-1.31, P = 0.34). In other six RCTs compared laparoscopic lavage with resection for treatment of perforated diverticulitis with peritonitis, the postoperative mortality rate was non-significant in both short-term (RR 1.55, 95% CI 0.79-3.04; P = 0.21) and long-term (RR 0.67, 95% CI 0.29-1.58; P = 0.36) follow up. CONCLUSIONS: LSR is not superior over OSR regarding postoperative morbidity and mortality for acute symptomatic diverticulitis. Furthermore, laparoscopic lavage was proved to be as safe as resection for perforated diverticulitis with peritonitis. Further RCTs are still needed to make an accurate decision regarding these and other procedures.

Role of Leisure Time Physical Activity in Cancer Prevention: Awareness and Practice among Medical Students at Cairo University

Background: Physical inactivity is accountable for a sizable proportion of breast and colorectal cancers and other non-communicable diseases. The higher the individual's awareness about the protective role of physical activity (PA) in reducing chronic disease, the greater the adoption of PA will be. Objectives: To determine the level of leisure-time physical activity (LTPA) and awareness towards the role of LTPA in cancer prevention among a sample of Medical students at Cairo University, Egypt. Subjects and Methods: A cross-sectional study, with multistage sampling (a total of 519 students from second to six year students) and a self administered questionnaire covering the study objectives. Results: A significant decrease in the actual?? level of LTPA was noted with students' year of enrollment at the medical school. However, their knowledge about roles of PA in preventing coronary heart, elevated blood pressure, and elevated cholesterol exceeded 80%, with steady increase in relation to the year of enrolment from the second to 6th years. Their knowledge about PA preventive influence for cancer was low irrespective of the year enrolment (32.2% for prevention of colon and 16.2% for breast cancers). The main sources of knowledge about the role of PA in cancer prevention were the internet and media (77%). Conclusion: The students demonstrated a decline in their LTPA coupled with poor knowledge about the role of LTPA in cancer prevention. Revision of the current curricula should be considered with inclusion of more information on the role of LTPA in cancer prevention to facilitate better awareness of medical students and through them their future patients.