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炎症性肠病与激进性前列腺切除术后在医院的不良结果
Calogero Catanzaro1, Natali Rodriguez Peñaranda2, Andrea Marmiroli3
1Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
经过激进前列腺切除术 (RP) 的炎症性肠病 (IBD) 患者面临更高的住院并发症风险. 克罗恩病患者的结果比性结肠炎患者更严重,开放式RP比微创性RP更高风险.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 胃肠病学 胃肠病学
- 健康 结果 研究 研究 结果
背景情况:
- 炎症性肠病 (IBD) 对前列腺癌 (PCa) 激进前列腺切除术 (RP) 后的结果的影响尚未得到充分证实.
- 囊括克朗氏病 (CD) 和性结肠炎 (UC) 的IBD是一种慢性炎症状况,可能会影响手术的结果.
研究的目的:
- 调查IBD (CD和UC) 与非转移性PCa.RP后不良住院结果之间的关联.
- 为了比较IBD患者的最小侵入性RP (MIRP) 和开放式RP (ORP) 与没有IBD患者之间的结果.
主要方法:
- 使用国家住院患者样本 (2000-2019) 数据库进行描述性分析.
- 使用倾向得分匹配和多变量逻辑回归模型.
- 患者根据IBD状态 (CD,UC,无IBD) 和RP方法 (MIRP,ORP) 分层.
主要成果:
- 在251,334名RP患者中,0.2%患有CD,0.2%患有UC.
- 与没有IBD患者相比,接受MIRP或ORP的CD患者的整体和术后并发症率明显更高.
- 接受ORP的UC患者的整体和手术内并发症率较高,而MIRP与非IBD患者相比,停留时间较长.
- 在CD和UC组中,ORP与非IBD患者相比,与MIRP相比,ORP与更不利的结果有关.
结论:
- 与没有IBD的患者相比,接受RP的CD和UC患者在医院的治疗结果更差.
- 在CD患者中,不良结果似乎比UC患者更严重.
- 在IBD患者中,微创激进前列腺切除术 (MIRP) 与开放激进前列腺切除术 (ORP) 相比,与较少的不良结果有关.
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