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在克罗恩病手术期间留下患病的小肠:长期结果
Imerio Angriman1, Silvia Degasperi2, Claudia Mescoli3
1Chirurgia Generale 3 Unit, Azienda Ospedale Università di Padova, Via Giustiniani 2, 35128, Padua, Italy.
Surgery today
|October 26, 2023
概括
对于克罗恩病 (CD) 的狭窄整形手术减少了肠道炎症,即使有疾病的肠道仍然存在. 然而,由于纤维化和多焦点性,留下患病的组织增加了重新手术的风险.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 炎症性肠道疾病研究研究
背景情况:
- 克罗恩氏病 (CD) 经常导致狭窄,通常使用肠节省技术进行管理.
- 评估在狭窄整形术后留下患病的肠道对炎症的影响对于患者的结果至关重要.
研究的目的:
- 分析狭窄整形术后肠道和全身炎症的变化,特别是当有疾病的肠道被保留时.
- 为了比较患有紧缩性CD的患者的狭窄性整形术和完整的疾病肠切除之间的结果.
主要方法:
- 对42名接受狭窄造形手术的患者进行了回顾性分析,以严格控制CD.
- 倾向性得分匹配对照组接受完整的疾病肠切除.
- 生物幽默标记和磁共振成像 (MRI) 在手术后1,6和12个月进行评估.
主要成果:
- 便中的calprotectin在12个月后降低,在strictureplasty和6个月后切除.
- 在狭窄整形术后,MRI显示明显扩散系数 (ADC),墙壁厚度,玛丽亚和克莱蒙特分数有显著改善.
- 与切除组相比,狭窄整形组中手术复发的频率更高.
结论:
- 狭窄整形导致肠道炎症活动降低,尽管保留了患病的肠道.
- 剩余的肠病增加了重新手术的风险,可能是由于纤维缩小症和多焦点性质的CD.
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