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对于炎症性与复杂性克罗恩病的阴茎切除后的长期比较结果. 一个多中心的,回顾性研究 (Crohn's-Urg)
Nicolas Avellaneda1, Annalisa Maroli2, Gianluca Pellino3
1Department of Surgery, Aarhus University Hospital, Denmark; Grupo Argentino de Enfermedad de Crohn y Colitis Ulcerosa (GADECCU), Argentina.
概括
在克罗恩病 (CD) 中,早期阴道切除 (ICR) 对不复杂和复杂的炎症表型都显示出类似的长期结果. 优化手术和医疗护理可以改善结果,甚至在不那么复杂的CD病例中支持手术.
科学领域:
- 胃肠病学 胃肠病学
- 外科胃肠道外科手术
- 炎症性肠道疾病研究研究
背景情况:
- 对于克罗恩病 (CD) 的手术干预通常是为并发症或治疗失败而保留的.
- 在不复杂的炎症性CD中,早期乳房切除 (ICR) 的长期益处与复杂的病例相比仍然存在争议.
研究的目的:
- 评估和比较ICR的长期结果在没有并发症 (炎症) 和复杂CD表型的患者中.
- 确定影响CD患者在ICR后疾病复发的因素.
主要方法:
- 2013年接受手术 (2012-2022) 的患者 (291例无并发性疾病) 的国际,多中心,回顾性队列研究.
- 主要终点:内镜疾病复发. 二级终点:临床复发,手术复发,便calprotectin,以及危险因素.
- 统计分析包括卡普兰-梅尔估计,考克斯回归和多变量建模.
主要成果:
- 尽管在复杂的CD中手术前贫血和新生/开放手术的发病率较高,但长期内镜,临床和手术复发率在两组之间是可比的.
- 腹腔镜手术和术后预防是预防复发的保护因素.
- 术前贫血和积极的手术边缘被确定为增加复发的风险因素.
结论:
- 在ICR后的长期结果与炎症性和复杂性CD相似,当适当管理时.
- 优化术后护理和解决可修改的风险因素对于改善结果至关重要.
- 这些发现支持考虑手术干预,包括ICR,即使在不那么复杂的CD表现.
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