Scandinavian Journal of Gastroenterology最新文献

{"title":"Meckel's diverticulum discovered by capsule endoscopy: a systematic review of case reports.","authors":"Lea Østergaard Hansen, Camilla Thorndal, Alexandra Agache, Anastasios Koulaouzidis","doi":"10.1080/00365521.2025.2487536","DOIUrl":"https://doi.org/10.1080/00365521.2025.2487536","url":null,"abstract":"<p><strong>Objectives: </strong>Capsule endoscopy has achieved its place as a diagnostic tool in a clinical setting, especially in the small bowel. The most frequent malformation of the gastrointestinal tract (Meckel's Diverticulum) has therefore been discovered incidentally by capsule endoscopies multiple times. However, it is still not a regular diagnostic modality when the pathology is suspected. In this review of case reports, we aim to evaluate the knowledge and rationales of using capsule endoscopy as a diagnostic tool for Meckel's diverticulum.</p><p><strong>Methods: </strong>We performed a search through Pubmed and Embase to find all publications describing cases of Meckel's diverticulum diagnosed by capsule endoscopy. All data was collected, and a stratification based on age group (adult versus pediatric patients) was performed.</p><p><strong>Results: </strong>The search resulted in 43 cases of Meckel's diverticulum diagnosed with capsule endoscopy, reported in 33 publications. The majority of the patients were male, with a median age of 20 years, and had an average of three negative investigations performed prior to capsule endoscopy. The three most commonly used investigations were upper and lower endoscopy and Meckel's scan. The most frequent finding on capsule endoscopy was the double lumen sign.</p><p><strong>Conclusion: </strong>The case reports indicate that capsule endoscopy can and has been used as a diagnostic tool for Meckel Diverticulum going back as far as 2002, with the most common finding being the double lumen sign. But it also highlights that patients too often go through multiple negative investigations before having a capsule endoscopy performed.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iron deficiency should not be accepted in patients with inflammatory bowel disease - a Scandinavian expert opinion.","authors":"Trond Espen Detlie, Johan Burisch, Jørgen Jahnsen, Ole Bonderup, Per M Hellström, Stefan Lindgren, Svein Oskar Frigstad","doi":"10.1080/00365521.2025.2487907","DOIUrl":"https://doi.org/10.1080/00365521.2025.2487907","url":null,"abstract":"<p><strong>Aim: </strong>In this paper, we aim to explain the reason why iron deficiency (ID) is common in patients with inflammatory bowel disease (IBD), how to better apply diagnostic tools to uncover the state of ID as well as how to interpret the results, and not least, how to treat ID in this group of patients.</p><p><strong>Methods: </strong>This article is an expert review and opinion paper on a topic that is too often forgotten in clinical practice. We have not performed a systematic review, but we present the most important research allocated to the topic to substantiate an expert opinion.</p><p><strong>Results: </strong>This position paper summarises the pathophysiology of ID and gives recommendations on the monitoring and treatment of ID in IBD. ID with or without concurrent anaemia (IDA) is the most common systemic complication in patients with IBD, related to both disease activity and severity. It has consequences both for health-related quality of life and future course of disease of the IBD patient. Intravenous iron is an efficacious and well tolerated, but still underused, therapy for ID and IDA. Iron deficiency should be treated before symptoms of anaemia appear and quality of life is impacted. However, there is still limited awareness of how to detect and treat ID in clinical practice. Uncertainty regarding which diagnostic tests to use and how to interpret the results may also be responsible for variations in clinical practice. In addition, opinions on how to correct ID and IDA differ, in relation to both clinical efficacy and safety.</p><p><strong>Conclusion: </strong>The consequences of ID in patients with IBD are significant. Guidelines on diagnosis, treatment and follow-up of ID should be implemented. IDA is a manifestation of severe ID and preventive strategies focusing on efficient treatment of ID regardless of the level of haemoglobin should therefore be explored.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation of preventing gastric cancer by eliminating Helicobacter pylori infection in China.","authors":"Yan Li, Shengwen Zhu, Yashi Liu, Dezhi He, Yanliang Liu, Hongchao Li","doi":"10.1080/00365521.2025.2473020","DOIUrl":"10.1080/00365521.2025.2473020","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the cost-effectiveness of screening <i>Helicobacter pylori</i> (<i>H. pylori</i>) and determine the optimal screening strategy in China.</p><p><strong>Methods: </strong>A Markov model was used to assess the cost-effectiveness of 13 screen-and-treat strategies, varying starting ages (20, 30, 40) and screening frequencies (no screening, once per lifetime, every 2, 3, or 5 years until age 50). For each scenario, 1,000,000 individuals were simulated. Outcomes were costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), and the number needed to treat (NNT) to prevent a gastric cancer. Deterministic and probabilistic sensitivity analyses tested the model's robustness.</p><p><strong>Results: </strong>Compared with no screening, screening at 20, 30, and 40 years of age once per lifetime were all cost-effective, with ICERs of -$40.37, -$78.28, and -$135.69 per QALY gained, respectively. NNT of the three strategies were 72, 63, and 55. Screening with a high frequency was associated with higher cost and QALYs; in the probabilistic sensitivity analyses, no matter the initial screening age, screening every 2 years would be the optimal strategy.</p><p><strong>Conclusion: </strong>Screening for <i>H. pylori</i> is a cost-saving and effective way to prevent gastric cancer in China. To prevent more gastric cancer, the population should take an H. pylori test from the age of 20 with a frequency of every 5 years in low gastric cancer incidence areas or age, with a frequency of every 2 years in high gastric cancer incidence areas or age.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"327-335"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term use of colchicine is associated with incident cirrhosis: a real-world cohort study.","authors":"Mohammad E Naffaa, Fadi Hassan, Helana Jeries, Dikla Dror, Vered Rozenberg, Gabriel Chodick, Michal Carmiel","doi":"10.1080/00365521.2025.2475488","DOIUrl":"10.1080/00365521.2025.2475488","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic effect of colchicine on the liver was not studied enough. We aimed to examine the association between long term colchicine use and incident cirrhosis among new colchicine initiators.</p><p><strong>Study: </strong>Using database of Maccabi Healthcare Services (MHS), we included all patients aged ≥18 years old who initiated colchicine between 1 January 2000 and 31 December 2018 and followed them until the earliest of the following: incident cirrhosis, leaving MHS, death or 31 December 2020. Incident cirrhosis was diagnosed according to ICD-9 code. We defined incident decompensated cirrhosis as the first presentation of cirrhosis, once ascites, encephalopathy and/or variceal bleeding were diagnosed within a period of 90 days before until 90 days after incident cirrhosis. Exposure to colchicine was evaluated in two manners: proportion of months covered (PMC) and mean daily dose (MDD).</p><p><strong>Results: </strong>A total of 21,773 eligible patients were included. We identified 129 incident cases of cirrhosis. Seventy-six (59%) had decompensated cirrhosis, as a first clinical presentation of cirrhosis. Familial Mediterranean Fever (FMF), BMI > 40, FIBROSIS-4 (FIB-4) score and colchicine PMC were all significantly associated with incident cirrhosis. Patients in '60-80%' PMC group had the highest risk for developing cirrhosis (hazard ratio (HR) 3.68, 95% confidence interval (CI) 2.23-6.07). The risk was higher for patients on colchicine >60 months (HR 6.69, 95% CI 3.56-12.56).</p><p><strong>Conclusions: </strong>long term colchicine use is associated with incident cirrhosis, mainly with decompensation at the time of diagnosis. Long term colchicine treatment should be limited to diseases with no other alternative, such as FMF.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"361-367"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter analysis of endoscopic full-thickness resection for gastrointestinal lesions in Poland.","authors":"Pawel Rogalski, Wojciech Korcz, Nastazja Dagny Pilonis, Jacek Drzewiecki, Andrzej Bialek, Marta Minkiewicz, Andrzej Baniukiewicz, Andrzej Dabrowski, Michal Jozwa, Piotr Gietka, Piotr Krolikowski, Maciej Gonciarz, Mateusz Jagielski, Marek Jackowski, Jakub Szlak, Wladyslaw Januszewicz, Michal Filip Kaminski","doi":"10.1080/00365521.2025.2463950","DOIUrl":"10.1080/00365521.2025.2463950","url":null,"abstract":"<p><strong>Objectives: </strong>The full thickness resection is an innovative technique that enables non-exposed endoscopic full-thickness resection (EFTR) of superficial and subepithelial gastrointestinal lesions. This retrospective, multicenter study evaluated the effectiveness and safety of EFTR in gastroduodenal and colorectal resections.</p><p><strong>Materials and methods: </strong>Data from 105 consecutive EFTR procedures at 6 Polish endoscopic centers were analyzed. Patients were divided into three groups: 'difficult adenoma', adenocarcinoma, or subepithelial lesion (SEL). Outcomes assessed were R0 resection and adverse event rates, with subgroup analysis.</p><p><strong>Results: </strong>The study included 105 patients (mean age: 67 ± 10.3 years; 59% male): 48 (46%) with 'difficult adenoma', 31 (30%) with adenocarcinoma, and 26 (25%) with SEL. Of these, 82 patients (78%) underwent colorectal EFTR, while 23 (22%) underwent gastroduodenal EFTR. Technical success was achieved in 101 procedures (96%), with a median time of 30 (20; 40) minutes. Among the technically successful EFTRs, R0 resection was confirmed in 86 patients (97%): 18 (95%) in the SEL group, 45 (100%) in the 'difficult adenoma' group, and 23 (92%) in the adenocarcinoma group (<i>p</i> = 0.1806). In 13 EFTR procedures (13%), a scar from a previous endoscopic resection was removed without any pathological lesion. Curative resections were obtained in 21 (88%) patients in the SEL group and 20 (67%) patients in the adenocarcinoma group (<i>p</i> = 0.0001). Clinical adverse events occurred in 12 patients (11%): Clavien-Dindo grade I (5%), II (2%), and IIIb (5%).</p><p><strong>Conclusions: </strong>EFTR is reasonably safe and effective for resection of colorectal and gastroduodenal lesions, which would otherwise most likely require surgical treatment.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"273-282"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single-center retrospective analysis of endorectal advancement flaps used for the treatment of simple rectovaginal fistulas.","authors":"Xuexiao Li, Wanjin Shao, Guidong Sun","doi":"10.1080/00365521.2025.2468493","DOIUrl":"10.1080/00365521.2025.2468493","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effectiveness of endorectal advancement flaps for middle and low rectovaginal fistulas.</p><p><strong>Methods: </strong>A retrospective cohort of 57 patients who underwent surgery via an endorectal advancement flap in the RVF between July 2007 and March 2022 was generated. The clinical features of the patients were reviewed. The associations between fistula closure and diverse clinical parameters, including age, body mass index, diameter of the fistula, prior repair, pathological type, diverting stoma and operative method, were analyzed.</p><p><strong>Results: </strong>Congenital (<i>n</i> = 19, 33.33%) and obstetric (<i>n</i> = 19, 33.33%) injuries were the most common etiologies of rectovaginal fistulas. The success rate in patients who underwent a first repair was 66.7%, and the overall success rate was 70.2% after repetition of the same technique. There were no significant differences in the closure rate between the success and failure groups in age, body mass index, prior repair, preoperative colostomy, or pathological type (<i>p</i> > 0.05). However, a diameter greater than 1 cm predicted a lower success rate for both the first repair (<i>p</i> < 0.05) and the overall procedure (<i>p</i> < 0.05). Two cases of failure with a diameter greater than 1 cm succeeded after a sphincter repair procedure half a year later.</p><p><strong>Conclusion: </strong>The endorectal advancement flap is safe and effective for removing simple rectovaginal fistulas at the middle and lower positions. A diameter greater than 1 cm is an independent risk factor for this surgical technique, and sphincteroplasty may be a better choice for this condition.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"307-311"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stone density can predict the number of ESWL treatments needed in patients with pancreatic duct calculi.","authors":"Evgenija Lozova, Mia Rainio, Marianne Udd, Outi Lindström, Taija Korpela, Antti Kuuliala, Arto Mikkola, Leena Kylänpää","doi":"10.1080/00365521.2025.2475084","DOIUrl":"10.1080/00365521.2025.2475084","url":null,"abstract":"<p><strong>Objectives: </strong>Extracorporeal shock wave lithotripsy (ESWL) with endotherapy (ET) is the first-line treatment in patients with chronic pancreatitis (CP) and main pancreatic duct stone (PDS). Our study aimed to evaluate factors that predict the outcome of ESWL in CP patients with PDS.</p><p><strong>Methods: </strong>We retrospectively analyzed data of 166 patients with CP and radiopaque PDS. Computed tomography (CT) images were evaluated for stone density, stone size, main pancreatic duct (MPD) size, and skin-to-stone distance (SSD). Long-term pain relief results were determined <i>via</i> telephone interview in 100 patients.</p><p><strong>Results: </strong>Mean stone density (MSD) > 1336 HU predicted the need to perform more than one ESWL session (odds ratio [OR]: 1.002; 95% confidence interval [CI]: 1.001 to 1.003; <i>p</i> = 0.002), cut-off 1336 HU yielding 71% sensitivity and 65% specificity. Denser stones required more ESWL and following ET, with ≥4 ET sessions resulting in better technical success. (OR: 3.222; 95% CI: 1.240 to 8.371; <i>p</i> = 0.016). Overall technical success (complete stone fragmentation in ESWL or placing a stent past the stone in ET) rate was 81.3%. Clinical success (complete or partial pain relief at the end of the treatments) rate was 83.7% and remained at the same level also in the long-term follow-up (median 5.5 years). Stone size, MPD size, or SSD were not associated with any of the study outcomes.</p><p><strong>Conclusions: </strong>Higher MSD than 1336 HU predicts the need for more than one ESWL and ET sessions to fragment the stone and clear the duct, but when successful the long-term result is favorable.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"386-393"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applicability of colon capsule endoscopy for monitoring ulcerative colitis: a systematic review.","authors":"Mathilde Simone Rasmussen, Lea Østergaard Hansen, Ulrik Deding, Mark Bremholm Ellebæk, Jens Kjeldsen, Thomas Bjørsum-Meyer","doi":"10.1080/00365521.2025.2475081","DOIUrl":"10.1080/00365521.2025.2475081","url":null,"abstract":"<p><strong>Background: </strong>As the target of therapy in Ulcerative colitis (UC) has changed from symptomatic relief to mucosal healing, endoscopic visualization is mandatory. Colon capsule endoscopy (CCE) may serve as a less invasive and more tolerable alternative to standard colonoscopy (SC) for the monitoring of UC.</p><p><strong>Objectives: </strong>To evaluate the diagnostic accuracy, adverse events and tolerability for CCE compared to SC.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Data sources: </strong>A systematic literature search was conducted in PubMed, Embase and Web of Science.</p><p><strong>Methods: </strong>Search results were imported into Covidence and screened. Included studies underwent risk of bias assessment using Methodological Index for Non-Randomized Studies (MINORS), and relevant data, including completeness of the procedure, type of bowel preparation and adverse events, was extracted. Pooled estimates of diagnostic accuracy were calculated from the studies providing the necessary data.</p><p><strong>Results: </strong>Out of 2804 articles, six studies were eligible for inclusion. Three provided the necessary data to calculate pooled estimates of diagnostic accuracy in recognizing mucosal inflammation: pooled sensitivity of 93%, specificity of 68.8%, positive predictive value of 89.4%, and negative predictive value of 78.6%. The adverse events, such as nausea and abdominal distension, were predominantly related to bowel preparation regimens.</p><p><strong>Conclusion: </strong>CCE has the potential for monitoring UC. However, the specificity and NPV must be improved. Bowel preparation regimens must be optimized to improve patient experience and the effectiveness of CCE.</p><p><strong>Registration: </strong>Prospero ID CRD42023450210.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"336-342"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative incidence and prevalence of perianal diseases in patients with inflammatory bowel disease and in the population: a nationwide Swedish study.","authors":"Åsa H Everhov, Michael Eberhardson, Jonas Söderling, Caroline Nordenvall, Jonas Halfvarson, Jonas F Ludvigsson, Ola Olén, Pär Myrelid, Hans Strid, Henrik Hjortswang, Malin Olsson, Jonas L Bengtsson, Marie A Andersson, Pontus Karling, Martin Rejler, Susanna Jäghult, Ulrika L Fagerberg, Karl Mårild, Johann Hreinsson, Charlotte Hedin","doi":"10.1080/00365521.2025.2476669","DOIUrl":"10.1080/00365521.2025.2476669","url":null,"abstract":"<p><strong>Background: </strong>Perianal diseases are more common in patients with Crohn's disease (CD) than in the general population, but data are scarce in other inflammatory bowel disease (IBD) subtypes.</p><p><strong>Method: </strong>Using data from the Swedish National Patient Register (NPR) and SWIBREG, the national quality register for IBD, we estimated the cumulative incidence of perianal fistula/abscess and perianal diseases (fistula, abscess, stenosis, fissure or procedure code for perianal surgery) in relation to diagnosis, and the prevalence in 2023, in individuals with CD, ulcerative colitis (UC) and IBD-unclassified (IBD-U), and in a matched (age, sex, calendar year and region of residence) IBD-free cohort from the general population.</p><p><strong>Results: </strong>We identified 38,364 patients with incident IBD 2007-2017, and 98,229 patients with prevalent IBD as of 31 December 2022. The cumulative incidence of fistula/abscess was 6.7% at diagnosis, 8.3% at 1 year and 10.4% at 5 years in CD. The corresponding percentages in UC were 0.9%, 1.3% and 2.1%, and in IBD-U 2.4%, 3.1% and 4.5%, respectively. In 2023, 12.8%, 3.1% and 4.1% of patients with prevalent CD, UC and IBD-U had a history of fistula/abscess, compared to 0.8% in the general population. The corresponding numbers for perianal diseases were 19.7%, 7.4%, 8.6% and 2.2%.</p><p><strong>Conclusions: </strong>The cumulative incidence and prevalence of perianal diseases in Swedish patients with CD was in parity with reports from other countries, and in patients with UC and IBD-U, it was 3-4 times higher than in the population.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"349-354"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the protrusion of ileostomies and peristomal dermatitis: an observational study.","authors":"Gro Irene Lien, Keson Jaioun, Gunter Bock, Camilla Løvall, Berit Vollen, Giedrius Lauzikas, Geir Hoff","doi":"10.1080/00365521.2025.2475092","DOIUrl":"10.1080/00365521.2025.2475092","url":null,"abstract":"<p><strong>Objective: </strong>This is an observational study to explore possible changes in end-ileostomy stoma protrusion through years of modified surgical methods.</p><p><strong>Materials and methods: </strong>Patients with permanent end-ileostomy were eligible for inclusion. Patients were recruited from two outpatient clinics in South-East Norway and from the Norwegian society for patients with ostomy (NORILCO). Stoma protrusion was measured in upright and supine positions by study nurse (outpatient cohort) or by the patient (NORILCO cohort). Clinical information was obtained through patients' questionnaire replies. For analyses, a pragmatic 24-hour ileostomy protrusion score was created, where 16/24 of upright measurement constituted protrusion during daytime and 8/24 of supine measurement protrusion at sleep.</p><p><strong>Results: </strong>93 participated in the study, 32 from outpatient clinics and 61 from NORILCO. The outpatients cohort had shorter stoma history than the NORILCO cohort. There was a weak positive correlation between stoma protrusion and years since stoma was created (r_s =0.303, <i>p</i> < 0.003), but stoma protrusion appeared not to be related to surgical method. In both groups, there was some reduction in stoma protrusion from upright to supine position, from 2.5 cm upright in both groups to 2.0-2.2 cm supine.</p><p><strong>Conclusions: </strong>Stoma protrusion was positively associated with years since stoma was created, but not with surgical method (laparotomy or laparoscopy). A functional 24-hour protrusion score may reduce the effect of clustering of measurements due to end-digit preferences and a preoccupied focus on 2 cm as the tipping point for skin problems. Further and larger studies are needed with special attention to reduce selection bias.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"322-326"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}