在初始发 diverticulitis 后的长期随访:一个13年的更新
Sarah N Anwar1,2, Gabrielle E Dombek1, Caroline E Hayes1,2
1Division of Colon and Rectal Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts.
Diseases of the colon and rectum
|November 7, 2024
概括
超过一半的患者经历了单次发作后的复发性分歧炎,女性性别和特定疾病特征增加了风险. 这些因素对于讨论选择性切除术决定至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 流行病学 流行病学
背景情况:
- 在患有复发性分泌体炎的患者中,选择性西格体切除术的决定仍然不清楚.
- 目前的指导方针强调个性化外科医生-病人决策.
- 预测长期复发风险对于指导治疗策略至关重要.
研究的目的:
- 评估初始发作后白炎复发的长期发病率和风险.
- 为了确定与复发性分泌体炎相关的预测因素.
- 为了为临床决策提供有关选择性切除术的信息.
主要方法:
- 对753名首次CT检测证实的分泌体炎患者的回顾性病例序列分析.
- 通过医疗记录审查和调查问卷收集的数据,平均随访时间为13.2年.
- 多变量分析用于确定复发的预测因素.
主要成果:
- 超过50% (52.4%) 的患者患有复发性分泌体炎,复发的中位时间为2.9年.
- 复发的关键预测因素包括女性性别,西格体疾病,燃烧疾病,更长的参与细分 (>5厘米) 和更大的脂肪串流直径 (>1.8厘米).
- 卡普兰-梅尔估计显示,1年后的无复发率为73.1%,5年后为47.9%,10年后为34.6%.
结论:
- 单次发作后白炎复发的长期发病率很大 (>50%).
- 特定的临床和成像因素与复发风险增加有关.
- 这些发现对于患者咨询和选择性sigmoid colectomy的共享决策至关重要.
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