在克罗恩病中切除性出血切除术 - 是时候质疑一个古老的教条了吗?
Keith J Geraghty1, Colum A O'Reilly2, Peter M Neary3,4
1Department of Surgery, University Hospital Waterford, Waterford, Ireland. Keithgeraghty21@rcsi.com.
Irish journal of medical science
|November 13, 2023
概括
切除性出血切除术可能适合克罗恩氏病患者,症状已得到控制. 这次审查在四项研究中的67名患者中没有发现直肠切除术或明显的伤口愈合问题.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
背景情况:
- 在克罗恩氏病中,瘤切除术是有争议的,因为人们担心伤口愈合不良和潜在的分泌切除术.
- 本综述旨在澄清切除性出血切除术在克罗恩病患者管理中的作用.
研究的目的:
- 审查克罗恩病患者切除性出血切除术结果的文献.
- 为了确定这一患者群体中这种外科手术的安全性和有效性.
主要方法:
- 使用Medline,PubMed和Cochrane控制试验中央注册表进行了系统的文献审查.
- 包括从2005年到现在的临床试验,重点是克罗恩病中切除性出血切除术.
- 不包括审查文章和案例报告,以确保数据质量.
主要成果:
- 分析了来自四项研究的67名患者.
- 没有报道过切口切除术或重大伤口愈合失败.
- 并发症包括手术后出血 (6%),门裂 (3%),门周 (3%),尿液保留 (1.5%) 和门收缩 (1.5%).
结论:
- 目前的证据表明,在克罗恩氏病患者的症状得到良好控制的情况下,可以考虑切除性出血栓切除术.
- 需要进一步的前性研究来证实这些发现,并确定最佳的外科手术方法 (开放式或封闭式).
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