重做回结肠切除术治疗克罗恩病,能像初次切除术一样减轻患者病情吗?

IF 1.1 4区 医学 Q3 SURGERY
David Hazzan, Gali Westrich, Lior Segev
{"title":"重做回结肠切除术治疗克罗恩病,能像初次切除术一样减轻患者病情吗?","authors":"David Hazzan, Gali Westrich, Lior Segev","doi":"10.1089/lap.2024.0146","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Objective:</i></b> We questioned how redo ileocolic resection (R-ICR) in Crohn's disease (CD) alleviates patients in the long-term compared with primary resection. <b><i>Methods:</i></b> A single-center retrospective analysis of patients who underwent an elective ICR without diversion between the years 2010-2022. The cohort was divided into two groups, namely, R-ICR and primary ileocolic resection (P-ICR). <b><i>Results:</i></b> The study included 181 patients, of which 30 patients are in the R-ICR group (mean age 42.3 years) and 151 patients in the P-ICR group (mean age 32.6 years). The R-ICR patients underwent an open approach (76.7% versus 25.2% among the P-ICR, <i>p</i> < .001), had significantly longer operations (mean 200.9 minutes versus 157.2 minutes, respectively, <i>P</i> = .002), and had higher estimated blood loss (mean 350 mL versus 267.4 mL, <i>P</i> = .043). The groups were similar in overall postoperative morbidity, severe postoperative complications (10% versus 13.2%, <i>P</i> = .762), and median length of hospital stay (12.1 days versus 7.4 days, <i>P</i> = .214). After a median follow-up of 64.2 months, there were no significant differences between the groups in terms of endoscopic recurrence (43.3% versus 60.9% in the P-ICR group, <i>P</i> = .104) or in clinical recurrence (43.3% versus 55.6%, respectively, <i>P</i> = .216), but the R-ICR had a significant higher rate of surgical recurrences (23.3% versus 5.3%, respectively, <i>P</i> = .004). <b><i>Conclusion:</i></b> R-ICR for CD is a significantly more challenging operation than the primary resection, and patients undergoing a R-ICR are more susceptible to a future surgical intervention than those having P-ICR.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Redo Ileocolic Resection for Crohn's Disease, Does It Palliate the Patients as Good as the Primary Resection?\",\"authors\":\"David Hazzan, Gali Westrich, Lior Segev\",\"doi\":\"10.1089/lap.2024.0146\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Objective:</i></b> We questioned how redo ileocolic resection (R-ICR) in Crohn's disease (CD) alleviates patients in the long-term compared with primary resection. <b><i>Methods:</i></b> A single-center retrospective analysis of patients who underwent an elective ICR without diversion between the years 2010-2022. The cohort was divided into two groups, namely, R-ICR and primary ileocolic resection (P-ICR). <b><i>Results:</i></b> The study included 181 patients, of which 30 patients are in the R-ICR group (mean age 42.3 years) and 151 patients in the P-ICR group (mean age 32.6 years). The R-ICR patients underwent an open approach (76.7% versus 25.2% among the P-ICR, <i>p</i> < .001), had significantly longer operations (mean 200.9 minutes versus 157.2 minutes, respectively, <i>P</i> = .002), and had higher estimated blood loss (mean 350 mL versus 267.4 mL, <i>P</i> = .043). The groups were similar in overall postoperative morbidity, severe postoperative complications (10% versus 13.2%, <i>P</i> = .762), and median length of hospital stay (12.1 days versus 7.4 days, <i>P</i> = .214). After a median follow-up of 64.2 months, there were no significant differences between the groups in terms of endoscopic recurrence (43.3% versus 60.9% in the P-ICR group, <i>P</i> = .104) or in clinical recurrence (43.3% versus 55.6%, respectively, <i>P</i> = .216), but the R-ICR had a significant higher rate of surgical recurrences (23.3% versus 5.3%, respectively, <i>P</i> = .004). <b><i>Conclusion:</i></b> R-ICR for CD is a significantly more challenging operation than the primary resection, and patients undergoing a R-ICR are more susceptible to a future surgical intervention than those having P-ICR.</p>\",\"PeriodicalId\":50166,\"journal\":{\"name\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/lap.2024.0146\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/15 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Laparoendoscopic & Advanced Surgical Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/lap.2024.0146","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/15 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

摘要

目的:我们对克罗恩病(CD)重做回肠结肠切除术(R-ICR)与原发性切除术相比如何长期缓解患者病情提出了疑问。方法:对2010-2022年间接受选择性ICR且未转流的患者进行单中心回顾性分析。患者分为两组,即 R-ICR 和原发性回结肠切除术(P-ICR)。研究结果研究共纳入 181 名患者,其中 R-ICR 组 30 人(平均年龄 42.3 岁),P-ICR 组 151 人(平均年龄 32.6 岁)。R-ICR 患者采用开放式方法(76.7% 对 25.2%,P < .001),手术时间明显更长(平均 200.9 分钟对 157.2 分钟,P = .002),估计失血量更高(平均 350 毫升对 267.4 毫升,P = .043)。两组的术后总发病率、术后严重并发症(10% 对 13.2%,P = .762)和中位住院时间(12.1 天对 7.4 天,P = .214)相似。中位随访 64.2 个月后,两组在内镜复发率(P-ICR 组为 43.3% 对 60.9%,P = .104)或临床复发率(分别为 43.3% 对 55.6%,P = .216)方面无明显差异,但 R-ICR 的手术复发率明显更高(分别为 23.3% 对 5.3%,P = .004)。结论R-ICR治疗CD的手术难度明显高于原发切除术,接受R-ICR的患者比接受P-ICR的患者更容易在未来接受手术治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Redo Ileocolic Resection for Crohn's Disease, Does It Palliate the Patients as Good as the Primary Resection?

Objective: We questioned how redo ileocolic resection (R-ICR) in Crohn's disease (CD) alleviates patients in the long-term compared with primary resection. Methods: A single-center retrospective analysis of patients who underwent an elective ICR without diversion between the years 2010-2022. The cohort was divided into two groups, namely, R-ICR and primary ileocolic resection (P-ICR). Results: The study included 181 patients, of which 30 patients are in the R-ICR group (mean age 42.3 years) and 151 patients in the P-ICR group (mean age 32.6 years). The R-ICR patients underwent an open approach (76.7% versus 25.2% among the P-ICR, p < .001), had significantly longer operations (mean 200.9 minutes versus 157.2 minutes, respectively, P = .002), and had higher estimated blood loss (mean 350 mL versus 267.4 mL, P = .043). The groups were similar in overall postoperative morbidity, severe postoperative complications (10% versus 13.2%, P = .762), and median length of hospital stay (12.1 days versus 7.4 days, P = .214). After a median follow-up of 64.2 months, there were no significant differences between the groups in terms of endoscopic recurrence (43.3% versus 60.9% in the P-ICR group, P = .104) or in clinical recurrence (43.3% versus 55.6%, respectively, P = .216), but the R-ICR had a significant higher rate of surgical recurrences (23.3% versus 5.3%, respectively, P = .004). Conclusion: R-ICR for CD is a significantly more challenging operation than the primary resection, and patients undergoing a R-ICR are more susceptible to a future surgical intervention than those having P-ICR.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信