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在早期与晚期败血症相关的囊中衰竭中进行重新状囊-门解剖

Marianna Maspero¹, Olga Lavryk², Jeremy Lipman³

¹Department of Colon and Rectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, OH. Electronic address: https://twitter.com/MariannaMaspero.

|August 5, 2023

概括

在修复性直肠切除术后囊失效的时间不会影响复原阴道囊解剖 (IPAA) 的长期结果. 雷多IPAA提供可比的囊存活率和生活质量,无论是早期还是晚期的败血症相关的囊衰竭.

科学领域:

胃肠病学胃肠病学
外科手术的结果
炎症性肠道疾病炎症性肠病

背景情况:

经过修复性直肠切除术与阴道囊解剖 (IPAA) 后的囊衰竭发生在5-15%的病例中,主要是由于败血症并发症.
了解故障时间对重复IPAA结果的影响对于患者管理至关重要.

研究的目的:

为了确定袋子失效的时间是否会影响患有败血症相关并发症的患者在重复IPAA后的长期结果.

主要方法:

一个前性收集的机构包数据库 (1988-2020) 的回顾性分析.
由于败血症并发症而进行重复IPAA的患者被分为早期 (在闭口腔关闭6个月内失败或从未关闭) 和晚期 (在6个月后失败) 组.
主要终点是囊存活;次要终点包括失败的原因和生活质量.

主要成果:

分析了335名患者:241名 (72%) 在早期失效组和94名 (28%) 在晚期失效组.
在早期失败 (68%) 中,管是最常见的原因,而在晚期失败中,管是最常见的原因 (63%).
在3,5年和10年的囊存活率在早期 (77%,75%,72%) 和晚期 (79%,75%,68%) 失败组之间是相似的 (P=.94). 在多变量分析中,克罗恩病是唯一与袋子失败相关的因素.

结论:

与败血症相关的囊失效的重复IPAA的结果在早期和晚期失效组之间是可比的.
在早期和晚期失败队列中,长期的囊生存和生活质量都是可以接受的.
克罗恩氏病是重复袋失效的重要危险因素.

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