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外围克罗恩囊手术的长期结果
Marie Schaad1, Alain Schoepfer2, Jean-Benoît Rossel3
1Service of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne, Bugnon 46, 1005 Lausanne, Switzerland.
Medicina (Kaunas, Lithuania)
|July 27, 2024
概括
周边克罗恩管治疗方法各不相同,管切除术提供更高的初始愈合,但往往需要更多的手术. 塞顿排水在许多患者中提供长期关闭,尽管可能需要额外的干预措施.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 炎症性肠道疾病研究研究
背景情况:
- 周围囊是克罗恩病 (CD) 的常见且具有挑战性的并发症.
- 目前对CD围囊的外科手术技术缺乏明显的优越方法,长期的结果,特别是对于Seton排水,没有充分记录.
- 经常需要重复的手术,影响患者的生活质量.
研究的目的:
- 为了评估长期治愈和复发率的周围囊在克罗恩病患者的大队伍.
- 为了比较不同初级手术干预的结果,围囊.
- 描述塞顿排水在管理复杂的长期有效性.
主要方法:
- 从瑞士炎症肠病 (IBD) 队列研究中对患者数据的回顾性分析.
- 包括365名患有近囊的患者,接受了576次手术干预.
- 平均随访时间为7.5年 (范围:0-12.6年).
主要成果:
- 39.7%的患者需要进行一次以上的手术.
- 粘膜切除术±粘膜滑动作为第一个干预措施,在7.5年内导致77.1%的关闭,但31%需要额外的手术.
- 作为最初的手术,塞顿排水在超过75%的患者中在10年后实现了囊关闭,52%的患者不需要进一步的手术.
结论:
- 虽然一线瘤切除术提供了高的初始愈合率,但很大一部分患者需要进一步的干预,而有些人仍然长期患有.
- 塞顿排水,结合医疗治疗,可以导致大量患者的囊成功关闭,尽管往往需要进一步的手术管理.
- 围克罗恩囊的最佳管理策略需要仔细考虑个体患者的因素和长期结果.
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