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保守的淋巴结采样在与非新生性炎症性肠病相关的肠切除中临床上是合适的:一个单一机构的经验

Chen Mayer¹, Tom Z Liang¹, Saman Karimi¹

¹From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore Maryland. Mayer is currently in the Department of Pathology at the Sheba Medical Center, Ramat Gan, Israel.

Archives of pathology & laboratory medicine

|September 5, 2024

概括

在非恶性炎症性肠病 (IBD) 切除中进行广泛的淋巴结检查是不具有成本效益的. 对淋巴结采样的一种保守方法可以优化资源,而不会影响IBD手术中的患者护理.

科学领域:

胃肠病学胃肠病学
手术病理学手术病理学
卫生经济学卫生经济学

背景情况:

在医疗保健中,高效的资源利用至关重要.
患有炎症性肠病 (IBD) 的患者通常需要为耐火性疾病或狭窄症进行手术.
与结直肠癌切除不同,在非恶性IBD切除中缺乏淋巴结检索的指导方针.

研究的目的:

评估在非恶性IBD切除中广泛的淋巴结检查的成本效益和实用性.
为了确定全面的淋巴结搜索是否会影响IBD手术中的患者结果.

主要方法:

从2011年到2018年,对354例非恶性IBD切除病例进行了回顾性分析.
排除了怀疑恶性瘤或癌症严重迹象的切除.
收集患者数据,切除类型,淋巴结数和随访信息.

主要成果:

51%的病例有≥12个淋巴结检查;只有1例 (0.3%) 显示微观侵入性癌症.
在4972个评估的淋巴结中没有检测到转移性疾病.
估计每例至少节省19,812美元和10.4分钟;在随访期间没有发生转移性疾病.

结论:

广泛的淋巴结评估,类似于结直肠癌方案,在没有临床或病理怀疑的非恶性IBD切除中是不必要的.
建议采用保守的淋巴结采样策略来优化资源.
通过保守的淋巴结采样来优化资源,不会影响IBD手术中的患者护理.

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